TP-584-NYC (9/19)
                 Department of Taxation and Finance                                                                             Recording office time stamp

                 Combined Real Estate Transfer Tax Return,
                 Credit Line Mortgage Certificate, and
                 Certification of Exemption from the
                 Payment of Estimated Personal Income 
                 Tax for the Conveyance of Real Property 
                 Located in New York City

See Form TP-584-NYC-I, Instructions for Form TP-584-NYC, before completing this form. Print or type.
Schedule A – Information relating to conveyance
  Grantor/Transferor         Name (if individual, last, first, middle initial) (    mark an   ifXmore than one grantor)               Social Security number (SSN)
    Individual
    Corporation              Mailing address                                                                                          SSN
    Partnership
    Estate/Trust             City                                              State                                        ZIP code  Employer identification number (EIN)
    Single member LLC
    Multi-member LLC            Single member’s name if grantor is a single         member LLC(see instructions)                      Single member EIN or SSN
    Other
  Grantee/Transferee         Name (if individual, last, first, middle initial) (    mark an   ifXmore than one grantee)               SSN
    Individual
    Corporation              Mailing address                                                                                          SSN
    Partnership
    Estate/Trust             City                                              State                                        ZIP code  EIN
    Single member LLC
    Multi-member LLC            Single member’s name if grantee is a single         member LLC (see instructions)                     Single member EIN or SSN
    Other
Location and description of property conveyed
 Tax map designation –          SWIS code               Street address                                                   City, town, or village County 
 Section, block & lot           (six digits)
 (include dots and dashes)

Type of property conveyed(mark an  Xin applicable box)
                                                                                                 Date of conveyance
1    One- to three-family house                   6          Apartment building                                                       Percentage of real property 
2    Residential cooperative                      7          Office building                                                          conveyed which is residential 
                                                                                                      month    day          year
3    Residential condominium                      8          Four-family dwelling                                                     real property               %
4    Vacant land                                  9          Other                                    Contract executed on or before            (see instructions)
                                                                                                      April 1, 2019 (see instructions)
5    Commercial/Industrial

Condition of conveyance (mark all that apply)             f.   Conveyance which consists of a                            l.  Option assignment or surrender
a.   Conveyance of fee interest                                mere change of identity or form of 
                                                               ownership or organization (attach 
                                                               Form TP-584.1, Schedule F)                                m.  Leasehold assignment or surrender
b.   Acquisition of a controlling interest (state 
     percentage acquired                     %)          g.    Conveyance for which credit for tax                      n.   Leasehold grant
                                                               previously paid will be claimed (attach 
                                                               Form TP-584.1, Schedule G)
c.     Transfer of a controlling interest (state                                                                        o.   Conveyance of an easement
        percentage transferred                 %)  h.          Conveyance of cooperative apartment(s)
                                                                                                                        p.   Conveyance for which exemption 
d.   Conveyance to cooperative housing                    i.   Syndication                                                   from transfer tax claimed (complete 
     corporation                                                                                                             Schedule B, Part 4)
                                                          j.   Conveyance of air rights or                              q.   Conveyance of property partly within 
e.   Conveyance pursuant to or in lieu of                      development rights                                            and partly outside the state
     foreclosure or enforcement of security              k.    Contract assignment                                       r.  Conveyance pursuant to divorce or separation
     interest (attach Form TP-584.1, Schedule E)                                                                        s.   Other (describe)
 For recording officer’s use      Amount received                                                Date received                        Transaction number
                                  Schedule B, Part 1   $
                                  Schedule B, Part 2   $
                                  Schedule B, Part 3   $ 

Page 2 of 4 TP-584-NYC (9/19)

Schedule B – Real estate transfer tax return (Tax Law Article 31)
Part 1 – Computation of tax due (in addition to the tax on line 4, you must compute the tax on lines 5a and 5b, if applicable)
 1  Enter amount of consideration for the conveyance   (if you are claiming a total exemption from tax, mark an  Xin the 
      Exemption claimed box, enter consideration and proceed to Part 4)  ................................ Exemption claimed                                        1.
  2 Continuing lien deduction (see instructions if property is taken subject to mortgage or lien)  ..........................................                      2.
  3 Taxable consideration (subtract line 2 from line 1)  ...................................................................................................       3.
  4 Tax: $2 for each $500, or fractional part thereof, of consideration on line 3 ........................................................                         4.
 5a Tax: $1.25 for each $500, or fractional part thereof, of consideration for the conveyance of residential real
       property located in New York City if the amount on line 3 is $3 million or more (see instructions)  .....................                                   5a.
 5b Tax: $1.25 for each $500, or fractional part thereof, of consideration for the conveyance of property located in 
      New York City other than residential real property, if the amount on line 1 is $2 million or more (see instructions)                                         5b.
  6 Total before credit(s) claimed (add lines 4, 5a, and 5b)  ...........................................................................................          6.
  7 Amount of credit claimed for tax previously paid (see instructions and attach Form TP-584.1, Schedule G)  ...............                                      7. 
  8 Total tax due* (subtract line 7 from line 6)  ................................................................................................................ 8.

Part 2 – Computation of additional tax due on the conveyance of residential real property for $1 million or more (see instructions)
  1 Enter amount of consideration for conveyance (from Part 1, line 1)  .......................................................................                    1.
  2 Taxable consideration (multiply line 1 by the percentage of the premises which is residential real property, as shown in Schedule A)  ...                      2.
  3 Total additional transfer tax due* (multiply line 2 by 1% (.01))  ..................................................................................           3.

Part 3 – Computation of supplemental tax due on the conveyance of residential real property, or interest therein,
         located in New York City, for $2 million or more (see instructions)
  1 Enter amount of consideration for conveyance (from Part 1, line 1)  .......................................................................                    1.
  2 Taxable consideration (multiply line 1 by the percentage of the premises which is residential real property, as shown in Schedule A)  ...                      2.
  3 Total supplemental transfer tax due* (multiply line 2 by tax rate, see instruction for rates)  ..........................................                      3.
    * The total tax (from Part 1, line 8; Part 2, line 3; and Part 3, line 3 above) is due within 15 days from 
       the date of conveyance.
Part 4 – Explanation of exemption claimed on Part 1, line 1 (mark an  Xin any boxes that apply)
The conveyance of real property is exempt from the real estate transfer tax for the following reason:
a.  Conveyance is to the United Nations, the United States of America, New York State, or any of their instrumentalities,
  agencies, or political subdivisions (or any public corporation, including a public corporation created pursuant to agreement
  or compact with another state or Canada)..........................................................................................................................................  a

b.  Conveyance is to secure a debt or other obligation............................................................................................................................  b
c.  Conveyance is without additional consideration to confirm, correct, modify, or supplement a prior conveyance ...............................  c
d.  Conveyance of real property is without consideration and not in connection with a sale, including conveyances conveying 
  realty as bona fide gifts .......................................................................................................................................................................  d

e.  Conveyance is given in connection with a tax sale.............................................................................................................................  e

f.  Conveyance is a mere change of identity or form of ownership or organization where there is no change in beneficial 
  ownership. (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property 
  comprising the cooperative dwelling or dwellings.) Attach Form TP-584.1, Schedule F ....................................................................   f

g.  Conveyance consists of deed of partition ...........................................................................................................................................  g

h.  Conveyance is given pursuant to the federal Bankruptcy Act.............................................................................................................  h 
i.  Conveyance consists of the execution of a contract to sell real property, without the use or occupancy of such property, or 
  the granting of an option to purchase real property, without the use or occupancy of such property .................................................   i

j.  Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the 
  consideration is less than $200,000 and such property was used solely by the grantor as the grantor’s personal residence 
  and consists of a one-, two-, or three-family house, an individual residential condominium unit, or the sale of stock 
  in a cooperative housing corporation in connection with the grant or transfer of a proprietary leasehold covering an 
  individual residential cooperative apartment.......................................................................................................................................   j
k.  Conveyance is not a conveyance within the meaning of Tax Law, Article 31, § 1401(e) (attach documents 
 supporting such claim)  ...........................................................................................................................................................................  k

                                                                                                              Page 3 of 4 TP-584-NYC (9/19)

Schedule C – Credit Line Mortgage Certificate (Tax Law Article 11)
Complete the following only if the interest being transferred is a fee simple interest.
This is to certify that:(mark an  Xin the appropriate box)

1.      The real property being sold or transferred is not subject to an outstanding credit line mortgage.

2.      The real property being sold or transferred is subject to an outstanding credit line mortgage. However, an exemption from the tax 
        is claimed for the following reason:
        a    The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the  
             real property (whether as a joint tenant, a tenant in common or otherwise) immediately before the transfer.

        b    The transfer of real property is (A) to a person or persons related by blood, marriage or adoption to the original obligor      
             or to one or more of the original obligors or (B) to a person or entity where 50% or more of the beneficial interest in such real  
             property after the transfer is held by the transferor or such related person or persons (as in the case of a transfer to a      
             trustee for the benefit of a minor or the transfer to a trust for the benefit of the transferor).

        c    The transfer of real property is a transfer to a trustee in bankruptcy, a receiver, assignee, or other officer of a court.

        d    The maximum principal amount secured by the credit line mortgage is $3 million or more, and the real property being sold   
          or transferred is not principally improved nor will it be improved by a one- to six-family owner-occupied residence or dwelling.

             Note: for purposes of determining whether the maximum principal amount secured is $3 million or more as described above, the 
             amounts secured by two or more credit line mortgages may be aggregated under certain circumstances. See TSB-M-96(6)-R for 
             more information regarding these aggregation requirements.

        e    Other (attach detailed explanation).

3.      The real property being transferred is presently subject to an outstanding credit line mortgage. However, no tax is due for the 
        following reason:
        a    A certificate of discharge of the credit line mortgage is being offered at the time of recording the deed.

        b    A check has been drawn payable for transmission to the credit line mortgagee or the mortgagee’s agent for the balance due, 
             and a satisfaction of such mortgage will be recorded as soon as it is available.

4.      The real property being transferred is subject to an outstanding credit line mortgage recorded in
        (insert liber and page or reel or other identification of the mortgage). The maximum principal amount of debt or obligation secured 
        by the mortgage is                                .  No exemption from tax is claimed and the tax of 
        is being paid herewith. (Make check payable to county clerk where deed will be recorded or, if the recording is to take place in 
        New York City but not in Richmond County, make check payable to the NYC Department of Finance.)

Signature (both the grantors and grantees must sign)

The undersigned certify that the above information contained in Schedules A, B, and C, including any return, certification, schedule, or 
attachment, is to the best of their knowledge, true and complete, and authorize the person(s) submitting such form on their behalf to receive a 
copy for purposes of recording the deed or other instrument effecting the conveyance.

              Grantor signature                           Title                      Grantee signature                                 Title

              Grantor signature                           Title                      Grantee signature                                 Title
Reminder: Did you complete all of the required information in Schedules A, B, and C? Are you required to complete Schedule D? If you 
marked e, f, or  gin Schedule A, did you complete Form TP-584.1? If the contract was executed prior to April 1, 2019, did you attach the 
necessary verification? Have you attached your check(s) made payable to the county clerk where recording will take place or, if the recording 
is in the New York City boroughs of Manhattan, Bronx, Brooklyn, or Queens, to theNYC Department of Finance? If no recording is required, 
send this return and your check(s), made payable to the NYS Department of Taxation and Finance, directly to the NYS Tax Department, 
RETT Return Processing, PO Box 5045, Albany NY 12205-0045. If not using U.S. Mail, see Publication 55, Designated Private Delivery 
Services.

Page 4 of 4 TP-584-NYC (9/19)

Schedule D – Certification of exemption from the payment of estimated personal income tax (Tax Law, Article 22, § 663)
Complete the following only if a fee simple interest or a cooperative unit is being transferred by an individual or estate or trust.
If the property is being conveyed by a referee pursuant to a foreclosure proceeding, proceed to Part 2, mark an  Xin the second box 
under Exemptions for nonresident transferors/sellers  , and sign at bottom.
Part 1 – New York State residents
If you are a New York State resident transferor/seller listed in Form TP-584-NYC, Schedule A (or an attachment to Form TP-584-NYC), you 
must sign the certification below. If one or more transferors/sellers of the real property or cooperative unit is a resident of New York State, 
each resident transferor/seller must sign in the space provided. If more space is needed, photocopy this Schedule D and submit as many 
schedules as necessary to accommodate all resident transferors/sellers.
Certification of resident transferors/sellers
This is to certify that at the time of the sale or transfer of the real property or cooperative unit, the transferor/seller as signed below was a 
resident of New York State, and therefore is not required to pay estimated personal income tax under Tax Law § 663(a) upon the sale or 
transfer of this real property or cooperative unit.
 Signature                                         Print full name                                      Date

  Signature                                        Print full name                                      Date

  Signature                                        Print full name                                      Date

  Signature                                        Print full name                                      Date

Note: A resident of New York State may still be required to pay estimated tax under Tax Law § 685(c), but not as a condition of recording a 
deed.
Part 2 – Nonresidents of New York State
If you are a nonresident of New York State listed as a transferor/seller in Form TP-584-NYC, Schedule A (or an attachment to 
Form TP-584-NYC) but are not required to pay estimated personal income tax because one of the exemptions below applies under 
Tax Law § 663(c), mark the box of the appropriate exemption below. If any one of the exemptions below applies to the transferor/seller, 
that transferor/seller is not required to pay estimated personal income tax to New York State under Tax Law § 663. Each nonresident 
transferor/seller who qualifies under one of the exemptions below must sign in the space provided. If more space is needed, photocopy this 
Schedule D and submit as many schedules as necessary to accommodate all nonresident transferors/sellers.
If none of these exemption statements apply, you must complete Form IT-2663, Nonresident Real Property Estimated Income Tax Payment 
Form  , or Form IT-2664, Nonresident Cooperative Unit Estimated Income Tax Payment Form. For more information, see Payment of estimated 
personal income tax, on Form TP-584-NYC-I, page 1.

Exemption for nonresident transferors/sellers
This is to certify that at the time of the sale or transfer of the real property or cooperative unit, the transferor/seller (grantor) of this real 
property or cooperative unit was a nonresident of New York State, but is not required to pay estimated personal income tax under Tax Law 
§ 663 due to one of the following exemptions:
            The real property or cooperative unit being sold or transferred qualifies in total as the transferor’s/seller’s principal residence 
            (within the meaning of Internal Revenue Code, section 121) from        to           (see instructions).
                                                                              Date       Date
            The transferor/seller is a mortgagor conveying the mortgaged property to a mortgagee in foreclosure, or in lieu of foreclosure with 
            no additional consideration.

            The transferor or transferee is an agency or authority of the United States of America, an agency or authority of New York State, 
            the Federal National Mortgage Association, the Federal Home Loan Mortgage Corporation, the Government National Mortgage 
            Association, or a private mortgage insurance company.
 Signature                                         Print full name                                      Date

  Signature                                        Print full name                                      Date

  Signature                                        Print full name                                      Date

  Signature                                        Print full name                                      Date