STATE OF NEW YORK)
: §§.:
COUNTY OF _____________)
Re: Title No. : ____________________
Property Address: ____________________
______________________________, being duly sworn, deposes and says:
1. I reside at the above property address, and am the owner of said premises. My possession of said premises has been peaceable and undisturbed, and my title has never been challenged or questioned. I know of no facts which might call into question my possession or title.
2. There are no federal tax claims or liens filed against me, and no judgments or liens of any kind against me filed in any court or administrative bureau of this State or of the United States, and I have not had bankruptcy proceedings filed by or against me, nor have I made any assignments for the benefit of creditors.
3. I am a citizen of the United States or a lawful permanent resident alien, and I am over 60 years old.
4. No work has been done at the premises which could result in the filing of a mechanics lien, or which could result in the creation of a lien by any municipal or governmental entity or agency.
5. There is no tenant or person in possession of the premises other than deponent.
6. If title to the premises has been certified by the title company to be in deponent and a now deceased spouse as tenants by the entireties, that we were never divorced nor changed our ownership of the premises during the lifetime of said spouse.
7. That I am the person entitled to any exemptions from real estate taxes which affect the premises.
8. I make this affidavit knowing that STEWART TITLE INSURANCE COMPANY is relying on the truth of my statements in issuing its loan policy of title insurance to the lender.
If more than one person is signing this affidavit, the singular terms used herein shall be deemed to be plural.
Sworn to before me this
_____ day of ____________, 20_____
Notary Public
No guidelines are available for this form at this time.