New York Title Research Corp
AFFIDAVIT UNDER SECTION 255 TAX LAW

STATE OFNEW YORK                 )
COUNTY OF                                 )  ss:

	                                   , being duly sworn, deposes and says:

1.	That he/she/it is the owner and holder of the hereinafter described mortgage, and is familiar with the facts and circumstances set forth herein.

2.	That an instrument herewith offered for recording is identified as follows:

(a)	Type of instrument: 
(b)	Date of Instrument:  
(c)	Parties:
Mortgagor: 
Mortgagee:  
(d)	Amount of Loan:  $
(e)	Mortgage Tax to be Paid:  -0-

3.	That the mortgage to which the above instrument is supplemental is identified as follows:
(a)	Dated:  
(b)	Parties:
Mortgagor:       
Mortgagee:
(c)	County of Recording
(d)	Date of Recording:
(e)	Liber and Page:
(f)	Mortgage Tax Paid:
(g)	Present Mortgage Balance:
(h)	Original Mortgage Amount:

4.	That the 				contained in this mortgage does not secure a 
re-loan or re-advance or new loan except the indebtedness secured by the previously recorded mortgage set out in paragraph three (3) above.

5.	That the exception from further tax is claimed under Section 255 of the Tax Law as to the said instrument herewith offered for recording.

6.	That the maximum amount secured hereunder and in conjunction with the previously recorded mortgage is:

Sworn to before me
this                day of             .

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