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INSTRUCTIONS(RP-5217-PDF-INS): WWW.Orpé..stata.ny US.
FOR COUNTY USE ONLY New York State Department of
C1. SWIS Code LY at G4 Taxation and Finance
C2. Date Deed Recorded | l / as Office of Real Property Tax Services
Month Year
RP- 5217-PDF
C3. Book | L, L, 3 u Oca. Bak [0.49.0 | Real Property Transfer Report (8/10)
PROPERTY INFORMATION |
/
1. Property 1627 Bailey Road
- Location
* STREET NUMBER * STREET NAME
14052
VILLA * ZIP CODE
2. Buyer Wa / 41,
iene FIRS f NAME
~~" LAST NAME/COMPANY FIRST NAME
* Me Indicate where future Tax Bills are to be sent
ng if other than buyer address(at bottom af form) ccaT icon cerry
Address
STREET NUMBER AND NAME CITY OR TOWN STATE ZIP CODE
4. Indicate the number of Assessment =] g poses = gp —_([_] Partofa Parcel (Only if Part of a Parcel) Check as they apply:
Roll parcels transferred on the deed 4A. Planning Board with Subdivision Authority Exists [|
5- Dore X _OR 50.00 4B, Subdivision Approval was Required for Transfer []
Property “FRONT FEET Sertnee eee
Size 4C. Parcel Approved for Subdivision with Map Provided []
Reinbolt David J.
6. Seller * LAST NAME/COMPANY FIRST NAME
Name :
Reinbolt Jo A.
LAST NAME/COMPANY FIRST NAME
Check the boxes below as they apply:
*7. Setect the description which most accurately describes the
use of the property at the time of sale: 8. Ownership Type is Condominium
OOOO
9. New Construction on a Vacant Land
A. One Family Residential
410A, Property Located within an Agricultural District
108. Buyer received a disclosure notice indicating that the property is in an
Agricultural District
| SALE INFORMATION | 15. Check one or more of these conditions as applicable to transfer:
A. Sale Between Relatives or Former Relatives
baad
41. Sale Contract Date 10/14/2018 B. Sale between Related Companies or Partners in Business.
C. One of the Buyers is also a Seller
* 42. Date of Sale/Transfer \\ aia, (2) 290 D. Buyer or Seller is Government Agency or Lending Institution
E. Deed Type not Warranty or Bargain and Sale (Specify Below)
F, Sale of Fractional or Less than Fee Interest (Specify Below)
*43, Full Sale Price "530, 000. 00 G. Significant Change in Property Between Taxable Status and Sale Dates
PE
H. Sale of Business is Included in Sale Price
( Full Sale Price is the total amount paid for the property including personal property. |, Other Unusual Factors Affecting Sale Price (Specify Below)
This payment may be in the form of cash, other property or goods, or the assumption of J. None
mortgages or other obligations.) Please round to the nearest whole dollar amount.
Comment(s) on Condition:
14. Indicate the value of personal
property Included in the sale 00
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill |
46. Year of Assessment Roil from which information taken(YY) 18 “17. Total Assessed Value 115,600
*48. Property Class 240 *49. School District Name Bast Aurora Union
*20. Tax Map Identifler(s)/Roll Identifier(s) (If more than four, attach sheet with additional identifier(s))
200.00-3~2
CERTIFICATION
| Certify that all of the items of information entered on this form are true and correct (to the best of my knowledge and belief) and | understand that the making of any willful
adh of m rial fact hereln relative to the making and filing of false instruments.
BUYER CONTACT INFORMATION
(Enter information for the buyer. Note: If buyer is LLC,society, association, corporation, joint stock company, estate or
entity that is not an individual agent or fiduciary, then a name and contact information of an individual/responsible
A by | } party who can answer questions regarding the transfer must be entered. Type or print clearly.)
O alep lk
ELLER SIGNATURE / °|
Rosinski Philip & Kelly
BUYER SIGNATURE
* LAST NAME FIRST NAME
ay Oh AWW" » : i \Y \\ ON “AREA CODE “TELEPHGNE NUMBER {Ex 9999999)
BUYER SIGNATURE
L627 Bailey Road
* STREET NUMBER * STREET NAME
East Aurora NY 14052
“CITY OR TOWN *STATE “ZIP CODE
BUYER'S ATTORNEY
Lorigo Ralph
LAST NAME FIRST NAME
(716) 824-7200
AREA CODE TELEPHONE NUMBER (Ex: 9999999}
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