STATE OF }
COUNTY OF }
, (the "applicant"), being duly sworn,
deposes and says that:
- The applicant is the owner of the property located at ,
identified on the tax maps of the City of New York as Borough ,
Block , Lot
(hereinafter referred to as the a "property");
- The applicant took title to the property on the day of
, 20, in an
arms length transaction in which the applicant paid a sale price of $;
- The applicant makes this affidavit to request that the City of New York cancel the lien on the
property for the following charges:
- To the best of the applicant’s knowledge, at the time of the closing of title to the property in the
transaction described in paragraph 2 herein, the records of the Department of Finance showed
that the charges listen in paragraph 3 herein were paid, and at such time the applicant was not
aware that the payment of any of the charges was not actually made, or that a check for
payment of any of the charges was rendered but was drawn on an account with insufficient
funds, nor was the applicant aware of any circumstances under which the City of New York
might determine that any of the above-referenced charges were unpaid;
- The applicant had no relationship with the party from whom the applicant purchased the
property other than an arms length buyer-seller relationship, and the consideration that the
applicant paid for the property was based on its market value, and therefore the applicant is a
bone fide purchaser of the property for value.
Signature of Property Owner
Print Name (and title, if applicable)
(INDIVIDUAL)
On this day of ,
20, before me personally appeared
, to me known and known to me to be the
person described in and who executed the foregoing, and acknowledged to me the execution thereof.
NOTARY PUBLIC
(PARTNERSHIP)
On this day of ,
20, before me personally came ,
to me known and known to me to be a member of , the firm described
in and which executed the foregoing and he acknowledged to me that he subscribed the name
of said firm thereto on behalf of said firm.
NOTARY PUBLIC
(CORPORATION)
On this day of ,
20, before me personally came ,
to me known, who, being by me duly sworn, did
depose and say that he resides in the City of , and is the
of , the corporation described in
and which executed the foregoing; that he knows the seal of said corporation; that the seal affixed to the foregoing is such
corporate seal; and that it was so affixed by order of the Board of Directors of said corporation and
that by like order he signed his/her name and official designation.
NOTARY PUBLIC