Affidavit - Indefinite Mortgage - Tax Law Section 256

State of } County of }ss:

being duly sworn, deposes and says:

That he is the of , the mortgagee in a certain mortgage instrument to be recorded herewith, made by , Mortgagor to , Mortgagee, dated affecting real property know as in the County of .

That the aforesaid instrument was given to secure an indebtedness or obligation in the sum of $ ; that the maximum amount secured at the execution of the said instrument or which under any contingency has since been or may be secured thereby at any time thereafter, including any and all advances, readvances, loans or reloans that may be made thereunder is $ .

Sworn to before me this day of 20

Notary Public