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PFLEAOOC PIFO UN FACOO SF INIVILY VVMEIN, VVAEPING UIN PUNIVI Nee 1 - Ff INSTRUCTIONS: Jatt HN www. /.OFps.s state: ny. us: or PHONE (518) 473-7222 (A (4 , ASSESSOR'S OFFICE : REAL PROPERTY—KRANSFER REPORT | JUL 3 0 20h EW YORK FR PE o17 ces iE G *e" aa RP-5217 Rev 3/97 1. Property Location STREET NUMBER STREET NAME City OR TOWN | ~ VILLAGE ZIP CODE 2.Buyer | LALLY | | PATRICK A, | | | | Name LAST NAME / COMPANY ) FIRST NAME : LAST NAME/COMPANY FIRST NAME . 3. Tax Indicate where future Tax Bills are to be sent - Billing _ if other than buyer address (at bottom of form) L a. __ _ Address LAST NAME / COMPANY | | FIRST NAME | _ | | | | | 7 STREET NUMBER AND STREET NAME CITYOR TOWN _ ) STATE ZIP CODE 4. Indicate the number of Assessment | 1 | (Only if Part of a Parcel) Check as they apply: - Roll parcels transferred on the deed _ # of Parcels OR Part of a Parcel . , _e | . | am ora marcel 4A. Planning Board with Subdivision Authority Exists [] 5. Deed . . 4B. Subdivision Approval was Required for Transfer [| Property Size Lo FRONT FEET | x | DEPTH lor L_. — / a 8 1 | 4C. Parcel Approved for Subdivision with Map Provided [] | _ ACRES 6. Seller |. G.T. RESOURCES, INC. a | __ _— oy Name LAST NAME / COMPANY FIRST NAME | : LAST NAME / COMPANY | FIRST NAME 7. Check the box below which most accurately describes the use of the property at the time of sale: Check the boxes below as they apply: | | 8. Ownership Type is Condominium [| A One Family Residential E. | Agricultural IT | Community Service 9. New Construction on Vacant Land [] B 2 or 3 Family Residential F - Commercial J Industrial 10A. Property Located within an Agricultural District [| C Residential Vacant Land G Apartment | K Public Service 10B. Buyer received a disclosure notice indicating C] D Non-Residential Vacant Land H Entertainment / Amusement L |__| Forest that the property is in an Agricultural District SALE INFORMATION | 15. Check one or more of these conditions as applicable to transfer: 11. Sale Contract Date — 06 / 12 / 01 | A P| Sale Between Relatives or Former Relatives Month Day . Year B Sale Between Related Companies or Partners in Business - 7) | C One of the Buyers is also a Seller 12. Date of Sale / Transfer [ ; i / j “ / Ol | D| | Buyer or Seller is Government Agency or Lending Institution Month ~ Day Year E|. | Deed Type not Warrantyor Bargain and Sale (Specify Below) F Sale of Fractional or Less than Fee Interest (Specify Below) . 1 6 0 . 600 0 G Significant Change in Property Between Taxable Status and Sale Dates 13. Full Sale Price | I i : N l i - 0,0 H Sale of Business is Included in Sale Price (Full Sale Price is the total amount paid for the property including personal property. I = Other Unusual Factors nneching Sale Price (Specify Below) — This payment may be in the form of cash, other property or goods, or the assumption of J ts. | None mortgages or other obligations.) Please round to the nearest whole dollar amount. — 14. Indicate the value of personal 0 0,0) property included in the sale 7 ; . 7 "ASSESSMENT INFORMATION - Data should reflect the latest Final AssessmentRoll and Tax Bil] 16. Year of Assessment Roll from 2° i | 17. Total A d Value (of all Is in transf \| _ 4 9. 9 9Q 0" which information taken 1 . Total Assessed Value (of all parcels in transfer ! ! 5 : 18. Property Class 2,40). |__| 19. School District Name | EAST AURORA U.F.S.D. #1 | 20. Tax Map Identifier(s) / Roll Identifier(s) (If more than four, attach sheet with additional identifier(s)) nd Ste, [ #199. 00-1- 22.211 ; oy _ | | | CERTIFICATIAN. ff