New York Title Research Corp
AFFIDAVIT OF EXEMPTION
SECTION 253	

State of New York                )
                                              )              SS.:
County of                              )

___________________________, being duly sworn, disposed and says:

	The undersigned is the (Attorney for the) owner and holder of the hereinafter described mortgage, and is fully familiar with the fact set forth herein.

	That the mortgage offered for recording dated        day of    
       , made by
			to
	
	That the mortgagee(s) is(are) a natural person or persons and the mortgaged premises consists of real property improved by a structure containing six residential dwelling units or less, each with separate cooking facilities.

	WHEREFORE, your deponent respectfully requests that the mortgage 
offered for recording herein be exempted from the special additional mortgage recording tax set forth in Section 253 (1)(a) of the tax law.

_____________________________

Sworn to before me
this        day of                    

____________________