ࡱ> EGBCD5@ ,xbjbj22 ,~XXqN~A~A~A~A$C$hE>NNNNN}T Wfffffff$jRlvgAYNNYYgNNBh^^^Y^NNf^Yf^^^^NE .8t~AoY2^_4Xh0h^Hm[Hm^Hm^^YYYgg?~A^ ~ATP-584 (3/07)  New York State Department of Taxation and Finance Combined Real Estate Transfer Tax Return, Credit Line Mortgage Certificate, and Certification of Exemption from the Payment of Estimated Personal Income Tax Effective September 1, 2003, use this 7/03 version of Form TP-584; previous versions may no longer be used.  Recording office time stampSee instructions (TP-584-I) before completing this form. Please print or type.Schedule A Information relating to conveyanceGrantor/Transferor  FORMCHECKBOX  Individual  FORMCHECKBOX  Corporation  FORMCHECKBOX  Partnership  FORMCHECKBOX  Estate/Trust  FORMCHECKBOX  OtherName (If individual; last, first, middle initial)  FORMTEXT      Social security number  FORMTEXT      Mailing address  FORMTEXT      Social security number  FORMTEXT      City State ZIP code  FORMTEXT      Federal employer ident. number  FORMTEXT      Grantee/Transferee  FORMCHECKBOX  Individual  FORMCHECKBOX  Corporation  FORMCHECKBOX  Partnership  FORMCHECKBOX  Estate/Trust  FORMCHECKBOX  OtherName (If individual; last, first, middle initial)  FORMTEXT      Social security number  FORMTEXT      Mailing address  FORMTEXT      Social security number  FORMTEXT      City State ZIP code  FORMTEXT      Federal employer ident. number  FORMTEXT      Location and description of property conveyedTax map designationAddressCity/VillageTownCountySectionBlockLot  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT      Type of property conveyed (check applicable box)1  FORMCHECKBOX  One-to three-family house 2  FORMCHECKBOX  Residential cooperative 3  FORMCHECKBOX  Residential condominium 4  FORMCHECKBOX  Vacant land5  FORMCHECKBOX  Commercial/Industrial 6  FORMCHECKBOX  Apartment building 7  FORMCHECKBOX  Office building 8  FORMCHECKBOX  Other  FORMTEXT      Date of conveyance  FORMTEXT        FORMTEXT        FORMTEXT       Month Day year Percentage of real property conveyed which is residential real property  FORMTEXT       % (see instructions)  Condition of conveyance (check all that apply) a.  FORMCHECKBOX  Conveyance of fee interest b.  FORMCHECKBOX  Acquisition of a controlling interest (state percentage acquired %) c.  FORMCHECKBOX  Transfer of a controlling interest (state percentage transferred %) d.  FORMCHECKBOX  Conveyance to cooperative housing corporation e.  FORMCHECKBOX  Conveyance pursuant to or in lieu of foreclosure or enforcement of security interest (attach Form TP-584.1, Schedule E) f. FORMCHECKBOX  Conveyance which consists of a mere change of identify or form of ownership or organization (attach Form TP-584.1, Schedule F) g. FORMCHECKBOX  Conveyance for which credit for tax previously paid will be claimed (attach Form TP-584.1, Schedule G) h. FORMCHECKBOX  Conveyance of cooperative apartment(s) i.  FORMCHECKBOX  Syndication j.  FORMCHECKBOX  Conveyance of air rights or development rights k  FORMCHECKBOX  Contract assignment l.  FORMCHECKBOX  Option assignment or surrender m. FORMCHECKBOX  Leasehold assignment or surrender n . FORMCHECKBOX  Leasehold grant o.  FORMCHECKBOX  Conveyance of an easement p.  FORMCHECKBOX  Conveyance for which exemption from transfer tax claimed (complete Schedule B, Part III ) q.  FORMCHECKBOX  Conveyance of property partly within and partly outside the state r.  FORMCHECKBOX  Other (describe)  FORMTEXT       For recording officer s use Amount received Schedule B., Part I $ FORMTEXT      Date receivedTransaction numberSchedule B., Part II $ FORMTEXT       Page 2 of 4 TP-584 (3/07) Schedule B  Real estate transfer tax return (Article 31 of the Tax Law) Part I Computation of tax due1 Enter amount of consideration for the conveyance (if you are claiming a total exemption from tax, check the exemption claimed box, enter consideration and proceed to Part III ) ............................  FORMCHECKBOX  Exemption claimed 1. FORMTEXT $0.002 Continuing lien deduction (see instructions if property is taken subject to mortgage or lien) ....................................2. FORMTEXT $0.003 Taxable consideration (subtract line 2 from line 1) .............................................................................................3. FORMTEXT  =Text42-Text43 $0.00$0.004 Tax: $2 for each $500, or fractional part thereof, of consideration on line 3 ..................................................4. FORMTEXT      5 Amount of credit claimed (see instructions and attach Form TP-584.1, Schedule G ) & & & & & & & .& & & & & .5. FORMTEXT      6 Total tax due* (subtract line 5 from line 4) ..........................................................................................................6. FORMTEXT  =Text45-Text46 $0.00$0.00 Part II Computation of additional tax due on the conveyance of residential real property for $1 million or more1 Enter amount of consideration for conveyance (from Part I , line 1) .................................................................1. FORMTEXT  =Text42 $0.00$0.002 Taxable consideration (multiply line 1 by the percentage of the premises which is residential real property, as shown in Schedule A ) ......2. FORMTEXT      3 Total additional transfer tax due* (multiply line 2 by 1% (.01)) ............................................................................3. FORMTEXT  =Text49*.01 $0.00$0.00 Part III  Explanation of exemption claimed on Part I, line 1 (check any boxes that apply) The conveyance of real property is exempt from the real estate transfer tax for the following reason: a. Conveyance is to the United Nations, the United States of America, the state of New York, or any of their instrumentalities, agencies, or political subdivisions (or any public corporation, including a public corporation created pursuant to agreement or compact with another state or Canada) ............................................................................................................................................a  FORMCHECKBOX   b. Conveyance is to secure a debt or other obligation.......................................................................................................................b  FORMCHECKBOX  c. Conveyance is without additional consideration to confirm, correct, modify, or supplement a prior conveyance..........................c  FORMCHECKBOX  d. Conveyance of real property is without consideration and not in connection with a sale, including conveyances conveying realty as bona fide gifts......................................................................................................................................................................d  FORMCHECKBOX  e. Conveyance is given in connection with a tax sale........................................................................................................................e  FORMCHECKBOX  f. Conveyance is a mere change of identity or form of ownership or organization where there is no change in beneficial ownership. (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.) Attach Form TP-584.1, Schedule F...................................................................f  FORMCHECKBOX  g. Conveyance consists of deed of partition......................................................................................................................................g  FORMCHECKBOX  h. Conveyance is given pursuant to the federal Bankruptcy Act.......................................................................................................h  FORMCHECKBOX  i. Conveyance consists of the execution of a contract to sell real property, without the use or occupancy of such property, or the granting of an option to purchase real property, without the use or occupancy of such property................................................i  FORMCHECKBOX  j. Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the consideration is less than $200,000 and such property was used solely by the grantor as the grantors personal residence and consists of a one-, two-, or three-family house, an individual residential condominium unit, or the sale of stock in a cooperative housing corporation in connection with the grant or transfer of a proprietary leasehold covering an individual residential cooperative apartment......................................................................................................................................................j  FORMCHECKBOX  k. Conveyance is not a conveyance within the meaning of section 1401(e) of Article 31 of the Tax Law (attach documents supporting such claim).......................................................................................................................................................................k  FORMCHECKBOX  l. Other (attach explanation)..............................................................................................................................................................l  FORMCHECKBOX  *Please make check(s) payable to the county clerk where the recording is to take place. If the recording is to take place in New York City, make check(s) payable to the NYC Department of Finance. If a recording is not required, send this return and your check(s) made payable to the NYS Department of Taxation and Finance, directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-5045. Page 3 of 4 TP-584 (3/07) Schedule C Credit Line Mortgage Certificate (Article 11 of the Tax Law) Complete the following only if the interest being transferred is a fee simple interest. I (we) certify that: (check the appropriate box) 1.  FORMCHECKBOX  The real property being sold or transferred is not subject to an outstanding credit line mortgage. 2.  FORMCHECKBOX  The real property being sold or transferred is subject to an outstanding credit line mortgage. However, an exemption from the tax is claimed for the following reason:  FORMCHECKBOX  The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the real property (whether as a joint tenant, a tenant in common or otherwise) immediately before the transfer.  FORMCHECKBOX  The transfer of real property is (A) to a person or persons related by blood, marriage or adoption to the original obligor or to one or more of the original obligors or (B) to a person or entity where 50% or more of the beneficial interest in such real property after the transfer is held by the transferor or such related person or persons (as in the case of a transfer to a trustee for the benefit of a minor or the transfer to a trust for the benefit of the transferor).  FORMCHECKBOX  The transfer of real property is a transfer to a trustee in bankruptcy, a receiver, assignee, or other officer of a court.  FORMCHECKBOX  The maximum principal amount secured by the credit line mortgage is $3,000,000 or more, and the real property being sold or transferred is not principally improved nor will it be improved by a one- to six-family owner-occupied residence or dwelling. Please note: for purposes of determining whether the maximum principal amount secured is $3,000,000 or more as described above, the amounts secured by two or more credit line mortgages may be aggregated under certain circumstances. See TSB-M-96(6)-R for more information regarding these aggregation requirements.  FORMCHECKBOX  Other (attach detailed explanation). 3.  FORMCHECKBOX  The real property being transferred is presently subject to an outstanding credit line mortgage. However, no tax is due for the following reason:  FORMCHECKBOX  A certificate of discharge of the credit line mortgage is being offered at the time of recording the deed.  FORMCHECKBOX  A check has been drawn payable for transmission to the credit line mortgagee or his agent for the balance due, and a satisfaction of such mortgage will be recorded as soon as it is available. 4.  FORMCHECKBOX  The real property being transferred is subject to an outstanding credit line mortgage recorded in  FORMTEXT       (insert liber and page or reel or other identification of the mortgage). The maximum principal amount of debt or obligation secured by the mortgage is  FORMTEXT      . No exemption from tax is claimed and the tax of  FORMTEXT       is being paid herewith. (Make check payable to county clerk where deed will be recorded or, if the recording is to take place in New York City, make check payable to the NYC Department of Finance.) Signature (both the grantor(s) and grantee(s) must sign) The undersigned certify that the above information contained in schedules A, B, and C, including any return, certification, schedule, or attachment, is to the best of his/her knowledge, true and complete. ___________________________________ ________________ ___________________________________ _______________ Grantor signature Title Grantee signature Title ___________________________________ ________________ ___________________________________ _______________ Grantor signature Title Grantee signature Title Reminder: Did you complete all of the required information in Schedules A, B, and C? Are you required to complete Schedule D? If you checked e, f, or g in Schedule A, did you complete Form TP-584.1? Have you attached your check(s) made payable to the county clerk where recording will take place or, if the recording is in New York City, to the NYC Department of Finance? If no recording is required, send your check(s), made payable to the Department of Taxation and Finance, directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-5045. Page 4 of 4 TP-584 (3/07) Schedule D - Certification of exemption from the payment of estimated personal income tax (Article 22, Tax Law section 663) Complete the following only if a fee simple interest is being transferred by an individual or estate or trust. Part I - New York State residents If you are a New York State resident transferor(s)/seller(s) listed in Schedule A of Form TP-584 (or an attachment to Form TP-584), you must sign the certification below. If one or more transferors/sellers of the property is a resident of New York State, each resident transferor/seller must sign in the space provided. If more space is needed, please photocopy this Schedule D and submit as many schedules as necessary to accommodate all resident transferors/sellers. 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