The undersigned purchaser(s)/borrower(s) each being duly and severally sworn, deposes and says:

1.I/We reside at

2.That I am/we are the sole owner(s) of the above premises. That we have owned the property described in the above-captioned title report since . I am/we are the record owner’s of said property as certified in the Title Report.

3.There are presently tenants in said premises. Each of said tenants either (a) is in possession under a lease containing a standard subordination clause subordinating said lease to all existing and future mortgages, or (b) is a statutory tenant. No tenant has any option to purchase or right of first refusal granted to it nor any recorded conveyance. There are no other persons or parties in possession other than as aforesaid.

4.I am/we are the purchaser(s)/borrower(s) affected by this transaction. That I/we have not been known by any other name for the last ten years except for:

5.That I am (we are) a citizen of the United States; over 21 years of age.

6. That I/we know of no other liens or mortgages (recorded or unrecorded) which will affect the property described in the above-referenced title report and I/We have not executed any instrument that is not disclosed by the above referenced title report.

7.That our ownership has been peaceable and undisturbed and I/we have no knowledge of any other parties’ claim to an interest in this property. There are no leases conferring rights of possession to any tenant; there are no persons in possession and no one has the right of possession to the premises as tenant or for any other reason except as set forth in the above referenced title report. There has not been any dispute with any neighbor with respect to the location of any structures on the property lines. The structures have been in existence in their current condition for at least two years. There are no actions pending affecting said premises.

8.That I (we) have read the Judgment, Bankruptcy, Federal Tax Lien, and Warrant returns. The returns, if any, listed in said report are not against said deponent but against other persons of the same or similar name and that I have never resided, worked or done business at any of the addresses stated in said Returns.

9.No proceeding in Bankruptcy has been instituted by or against me under any other name in any court or before any officer of any state or the United States and that there are no judgments or Federal Tax Liens against me (us) in any jurisdiction.

10. That there are no Parking Violations Bureau Judgments, Environmental Control Board Liens, Environmental Control Board Fire Liens or Transit Adjudication Bureau Judgments against me except for those referred to in Schedule B of the Certificate of Title.

11.There are no unpaid taxes, assessments, water charges or sewer rents against the premises now due and owing.

12.I am the same person entitled to the exemption as stated in the above-captioned title report.

Initials: Initials: -Page One of Two-


A.That to the best of my/our knowledge, there has been no work performed at the property by the City of New York, nor has any demand been made by the City of New York for any such work that has or may result in charges/liens by the N.Y.C. Department of Rent & Housing Maintenance Emergency Repair, the New York City Department of Health or the New York City Department of Environmental Protection.

B.To the best of my (our) knowledge, there are no street vaults, or if there are street vaults, any and all vault taxes have been paid to date.

C.That to the best of my (our) knowledge, there have been no repairs performed by the Emergency Service Division of the Department of Rent and Housing Maintenance of the City of New York.


I am (we are) aware of the payoff letter (s) from ; dated respectively showing the prior principal balance, unpaid interest and per diem, required to satisfy the existing mortgage(s) and that the same is/are correct in all respects.

In consideration of omitting the existing mortgage from your title policy to be issued. I hereby request you to fully pay off the existing mortgage totaling $, to be transmitted promptly to the holder of the mortgage(s) in satisfaction of my existing mortgage indebtedness, and do hereby agree to pay you, on demand, any additional monies required by the holder of said mortgage to enable you to obtain a satisfaction there of in recordable form. I further state that the lender has the right to deduct any shortages from the tax escrow account. If the mortgage(s) being paid off is an equity source/credit line mortgage, I (we) hereby consent to have the account frozen, and request that the holder of the mortgage (s) accept the payoff check as full settlement and close the account upon receipt of the proper payoff amount and issue a satisfaction(s) of mortgage within the required time period.


This affidavit has been executed and delivered in order to induce the Title Company to remove certain possible exceptions to title set forth in the above captioned title report and to issues its policy of title insurance covering said premises knowing that it will rely on the statements made herein.

Current or Forwarding Address:

BorrowerSocial Security or Federal ID #

BorrowerSocial Security or Federal ID #

BorrowerSocial Security or Federal ID #

Sworn to before me on this

day of , 20


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