Fillable Printable Affidavit in Connection with a No Consideration Transfer

Affidavit in Connection with a No Consideration Transfer

TITLE CO.: TITLE NO.:

DATE:

STATE OF NEW YORK, COUNTY OF )SS.:

Grantor (s) being duly sworn deposes and says under the penalties of perjury as follows:

I/we are the Grantor (s) in the deed dated _____________________________________ and delivered to

____________________________________________________________________________________

conveying title in the property known as:

([Section Block Lot ])

I/we hereby acknowledge and confirm the execution and delivery of said deed to the grantee(s) herein

named:

1. ___________________________________________________________________________________

2. ___________________________________________________________________________________

3. ___________________________________________________________________________________

The undersigned represents that the grounds upon which the claim of no consideration is based as follows:

_____________________________________________________________________________________

The aforementioned no consideration transfer was made solely for the grounds stated herein.

I/we affirmatively represent that said transfer does not leave insolvent, and is not done to hinder, delay or

fraud creditors. Therefore, any returns filed in collection with this no consideration deed shall be free from

any transfer taxes. This affidavit is made to induce

to issue its policy covering the above referenced premises, knowing that it relies upon the truth thereof.

____________________________

Sworn to before me on

___________________________

Notary Public State of New York