State: New York
State of )
ss.:
County of )
residing at
, being duly sworn, deposes and says:
That deponent, a , (assigned said contract of sale to)(entered into a new contract to resell said premises with) (as Assignee) (as Purchaser) on the day of , , that the price for said (Assignment) (Purchase) is the sum of $. That the deed was executed by , as grantor, and delivered to as grantee, and the consideration received by the grantor for said deed was the sum of $ . As indicated by the return of which this Affidavit is annexed, and upon which sum there (was) (was no) tax due (in the sum of $, a check in payment which is tendered herewith.)
That no tax is due on the difference between the sum of $, paid to the grantor for the delivery of the deed and the sum of $, paid to the (Assignor) (Seller) under the new contract as the price obtained on the (Assignment) (resale of said contractual right) was paid merely for the sale of rights arising out of a chose in action (see transmittal advice no. 118), and this Affidavit is made merely to reflect the actual transaction which took place.
SWORN TO BEFORE ME THIS
DAY OF ,
20
AFFIDAVIT NY11: AFFIDAVIT FOR AN ASSIGNED CONTRACT OR A RECONTRACT WHERE DEED IS GIVEN DIRECT FROM ULTIMATE SELLER TO ULTIMATE PURCHASER