Section 255 Affidavit
(Reverse Mortgage)

Section 255 Affidavit (Reverse Mortgage)

State of ]
County of ]ss:

, being duly sworn deposes and says:

1. I am , the owner and holder of the mortgage which is being submitted for recording. I am familiar with the facts set forth herein.

2. On , executed and delivered to a mortgage for property located at and known as Tax Lot , Block on the Tax Map of the , , County of , State of New York in the amount of $ .

3. The mortgage is a reverse mortgage and complies with the provisions of Section 280 (280A) of the Real Property Law.

4. The mortgagor(s) is (are) over the age of and he/she/they occupy the property as his/her/their principal residence.

5. The mortgage is on real property improved by a one-to-four family dwelling or condominium unit.

6. The deponent respectfully requests that this reverse mortgage tendered herewith for recording be declared exempt from taxation pursuant to the provisions of Section 252-A (2) of Article 11 of the Tax Laws of the State of New York.

Sworn to before me this
day of , 20.