THE CITY OF NEW YORK
DEPARTMENT OF HOUSING PRESERVATION AND DEVELOPMENT
AFFIDAVIT IN LIEU OF REGISTRATION STATEMENT
nyc.gov/hpd
County of _______________ ) SS.:
State of New York )
_________________________________________________, being duly sworn, deposes and says:
1) I am personally familiar with the real property known by the street address of (insert street address):
________________________________________________Block______________, Lot______________,
and make this Affidavit as (describe capacity in which affidavit is made) __________________________
in connection with a deed/lease/memorandum of lease (delete inapplicable description) which transfers an
interest in the above real property, that is dated _______________, and is
between_________________________ and_________________________________.
2) The statements made in the Affidavit are true of my own knowledge, and I submit this Affidavit in order
that this Instrument be accepted for recording without being accompanied by a registration statement, as
such is defined by Article 2 of Subchapter 4 of Chapter 2 of Title 27 of the Administrative Code of the
City of New York.
3) Exemption from registration is claimed because the Instrument affects neither (a) an entire multiple
dwelling as such is defined by §27-2004(a)(7) of Article 1 of Subchapter 1, of Chapter 2 of Title 27 of the
Administrative Code of the City of New York and New York State Multiple Dwelling Law §4(7) nor (b)
a private dwelling as such is defined by §27-2004 (a) (4) of Article 1 of Subchapter 1 of Chapter 2 of
Title 27 of the Administrative Code of the City of New York and of the New York State Multiple
Dwelling Law §4(6) that is required to register pursuant to, Article 2 of Subchapter 4 of Chapter 2 of Title
27 of the Administrative Code of the City of New York. The Instrument does not affect a multiple
dwelling because it affects the following (check applicable item):
a commercial building
a one-or two family dwelling whose owner or a family member resides in the dwelling
a condominium unit in a multiple dwelling
cooperative corporation shares relating to a single residential unit in a multiple dwelling
mineral, gas, water, air or other similar rights not affecting a multiple dwelling
lease of commercial space in a multiple dwelling
vacant land
4) I am aware that this Affidavit is required by law to be submitted in order that the Instrument be recorded
or accepted for recording without being accompanied by a registration statement. I am aware that any
false statements made in this Affidavit may be punishable as a felony or misdemeanor under Penal Law
Article 210 or as an offense under Administrative Code of the City of New York §10-154.
__________________________________________
Sworn To Before Me This Signature
________Day of ________2009
__________________________ Address ___________________________________
Notary Public Telephone # ________________________________
