AFFIDAVIT OF COMPLIANCE WITH SMOKE DETECTOR REQUIREMENTS FOR ONE- AND TWO-FAMILY DWELLINGS
(BRONX, KINGS, NEW YORK, QUEENS, & RICHMOND COUNTIES)

STATE OF 						)
COUNTY OF 						)
The undersigned, being duly sworn, depose and say under penalty of perjury that they are the grantor and grantee of the real property or of the cooperative shares in a cooperative corporation owning real property located at:
									,  		,
Street Address					       Unit/Apt.
					, New York, 		  		 (the Premises);
		County				           Block 	            Lot
That the Premises is a one or two family dwelling, or a cooperative apartment or condominium unit in a one- or two-family dwelling, and that installed in the Premises is an approved and operational smoke detecting device in compliance with the provisions of Article 6 of Subchapter 17 of Chapter 1 of Title 27 of the Administrative Code of the City of New York concerning smoke detecting devices;
That they make affidavit in compliance with New York City Administrative Code Section 11-2105 (g). (The signatures of at least one grantor and one grantee are required, and must be notarized).
													
Grantor Full Name						Grantor Full Name

													
Grantor Signature							Grantor Signature


Subscribed and Sworn before me this 	     			Subscribed and Sworn before me this 	     
day of 	    , 20	    .						day of 	    , 20	    .	
x								x					
Notary Public:							Notary Public:





These statements are made with the knowledge that a willfully false representation is unlawful and is punishable as a crime of perjury under Article 210 of the Penal Law.
NEW YORK CITY REAL PROPERTY TRANSFER TAX RETURNS FILED ON OR AFTER FEBRUARY 6th, 1990, WITH RESPECT TO THE CONVEYANCE OF A ONE- OR TWO-FAMILY DWELLING, OR A COOPERATIVE APARTMENT OR A CONDOMINIUM UNIT IN A ONE- OR TWO-FAMILY DWELLING, WILL NOT BE ACCEPTED FOR FILING UNLESS ACCOMPANIED BY THIS AFFIDAVIT.