STATE OF NEW YORK
AFFIDAVIT OF COMPLIANCE OF SMOKE ALARM INSTALLATION
IN ONE AND TWO FAMILY HOMES

STATE OF                              )
                                                ) SS:
COUNTY OF                         )

1.  I/We are the transferor(s) of the property described herein and attest that the property has installed on its premises an operable single station smoke detecting alarm device.

2.  The property is a one family dwelling located at:

__________________________________________________, New York (Town of Carmel)

3.  I/We make this affidavit in accordance with Section 378 subdivision 5 of the Executive Law.

                                                                                    _______________________________

                                                                                    _______________________________

Sworn to before me this day of 20

_____________________________
Notary Public