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$ New York, FOR VALUE RECEIVED, promise to

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Mortgage Note - Uniform Acknowledgment
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
$ New York,
FOR VALUE RECEIVED,
promise to pay to
or order, at
or at such other place as may be designated in writing by the holder of this note, the principal sum of
($ ) dollars
with interest thereon to be computed from the date hereof, at the rate of
( %) per centum
per annum and to be paid on the day of , next ensuing
and thereafter
IT IS HEREBY EXPRESSLY AGREED, that the said principal sum secured by this note shall become due at the option of
Mortgage Note - Uniform Acknowledgment
the holder thereof on the happening of any default or event by which, under the terms of the mortgage securing this note, said
principal sum may or shall become due and payable; also, that all of the covenants, conditions and agreements contained in
said mortgage are hereby made part of this instrument.
Presentment for payment, notice of dishonor, protest and notice of protest are hereby waived.
This note is secured by a mortgage made by the maker to the payee of even date herewith, on property situate in the
This note may not be changed or terminated orally.
IN PRESENCE OF:
Mortgage Note - Uniform Acknowledgment
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
State of New York, County of , ss:
On the day of in the year , before me,
the undersigned, personally appeared
,
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is
(are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their
capacity(ies), and that by his/her/their signature(s) on the
instrument, the individual(s), or the person upon behalf of which
the individual(s) acted, executed the instrument.
(signature and office of individual taking proof)
State of New York, County of , ss:
On the day of in the year , before me,
the undersigned, personally appeared
,
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is
(are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their
capacity(ies), and that by his/her/their signature(s) on the
instrument, the individual(s), or the person upon behalf of which
the individual(s) acted, executed the instrument.
(signature and office of individual taking proof)
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
State (or District of Columbia, Territory, or Foreign Country) of ss:
On the day of in the year , before me, the undersigned, personally appeared
, personally known to me or proved to me on the basis of satisfactory evidence to
be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the
same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf
of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in
the .
(insert the city or other political subdivision and the state or country or other place the acknowledgment was taken)
(signature and office of individual taking acknowledgment)
MORTGAGE NOTE –
U
NIFORM ACKNOWLEDGEMENT
TITLE NO.:
TO
DISTRICT:
SECTION:
BLOCK:
LOT:
PREMISES:
COUNTY:
RECORD AND RETURN TO:
Mortgage Note - Uniform Acknowledgment
RESERVE THIS SPACE FOR USE OF RECORDING OFFICE
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Completed 16 August 2021

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