GIT/REP-4a
(6-10)
State of New Jersey
WAIVER OF SELLER’S FILING REQUIREMENT OF
GIT/REP FORMS AND PAYMENT FOR CORRECTED DEED
WITH NO CONSIDERATION
(C.55, P.L. 2004)
(Please Print or Type)
OWNER(S) INFORMATION
Name(s)
Current Resident Address:
City, Town, Post Office
State
Zip Code
PROPERTY INFORMATION (Brief Property Description)
Block(s)
Lot(s)
Qualifier
Street Address:
City, Town, Post Office
State
Zip Code
OWNER(S) DECLARATION
The undersigned is (are) the title owner(s) of the real property identified under the "Property Information" section above. By
presenting this declaration fully completed and signed by me (us), I (we) represent that the deed to which this form is attached is for
corrective or confirmatory purposes only. In other words, the deed needs to be recorded or re-recorded solely due to a
typographical, clerical, property description or other scrivener error or omission and there is no consideration for the corrective or
confirmatory deed. The county recording officer will accept this form for recording along with such deed. The recording officer may
also, however, continue to accept the GIT/REP-4 form with the Division's raised seal in lieu of the GIT/REP-4A. By checking this
box
I certify that the Power of Attorney to represent the seller(s) has been previously recorded or is being recorded
simultaneously with the deed to which this form is attached.
This waiver form may be presented to the appropriate county recording officer for recording along with the deed of the owner as
identified in the information above. Accordingly, the county recording officer is hereby authorized to accept this waiver form in lieu of
any other GIT/REP form without any further payment of any tax on estimated income gain pursuant P.L. 2004, c. 55.
_________________
_________________________________________________________________
Date
Signature (Owner) Please indicate if Power of Attorney or Attorney in Fact
_________________
_________________________________________________________________
Date
Signature (Owner) Please indicate if Power of Attorney or Attorney in Fact