The undersigned, being duly sworn, deposes and says that:
He resides at the address shown at the foot hereof and holds the office as indicated
beneath his signature.
The amount of the Loan is $
The consideration for the loan to be paid and the other expenses heretofore incurred
or to be incurred in connection with and paid out of the Loan are (or are estimated to be)
as follows:
Commitment fee, if any, for the Loan: $
Examination of title and recording fees: $
Mortgage recording taxes: $
Fees of Lender's Construction Consultant: $
Fees of Lender's legal counsel: $
Interest on the Building Loan Mortgage $
Total $
The amount, if any, to be advanced from the Loan to repay amounts previously
advanced to the Borrower pursuant to Notices of Lending for costs of the Improvements
is: $
The amount, if any, to be advanced from the Loan to reimburse the Borrower for costs
of the Improvements expended by the Borrower after the commencement of the
Improvements but prior to the date hereof are itemized as follows:
Description of Cost of Improvement Amount
$
$
$
$
Total: $
The estimated amount to be advanced from the Loan for indirect costs of the
Improvements which may become due and payable after the date hereof and during the
construction of the Improvements (such as bond and insurance premiums, fees of
architects, engineers and surveyors, ground rents, taxes, assessments and water and sewer
rent) is: $
The net sum which the Borrower estimates will be available to it from the Loan to pay
contractors, subcontractors, laborers and materialmen for the Improvements is:
$
This affidavit is made pursuant to and in compliance with Section 22 of the Lien Law
of the State of New York.
If the Borrower is a corporation or partnership, this statement is verified by deponent
and no by Borrower because the Borrower is a corporation or partnership (of which the
deponent is an officer or general partner).
The facts stated above and any costs itemized on this statement are true to the
knowledge the undersigned.
