Fillable Printable Loan Borrower's Affidavit - New York

Loan Borrower's Affidavit - New York

State of New York]

County of_______________ ]ss:

The undersigned, being duly sworn, deposes and says that:

(1) He resides at the address shown at the foot hereof and holds the office as indicated

beneath his signature.

(2) The amount of the Loan is $_________________

(3) 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 $_____________________________

(4) 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: $____________________

(5) 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

a) $______________________________________

b) $______________________________________

c) $______________________________________

d) $______________________________________

Total: $___________________________________

(6) 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:

$___________________________________

(7) 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:

$___________________________________

(8) This affidavit is made pursuant to and in compliance with Section 22 of the Lien Law

of the State of New York.

(9) 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).

(10) The facts stated above and any costs itemized on this statement are true to the

knowledge the undersigned.

___________________________________

Sworn to before me this _____ day

of ______________, 20____.

___________________________________

Notary Public