2025-121 (2)THE SECOND AMENDMENT TO LAND LEASE AGREEMENT
This Second Amendment to Land Lease Agreement (this "Amendment") is made effective as of the latter
signature date hereof (the "Effective Date") by and between Town of Wappinger NY ("Landlord") and ACC
Tower Sub, LLC, a Delaware limited liability company ("Tenant") (Landlord and Tenant being collectively
referred to herein as the "Parties").
RECITALS
WHEREAS, Landlord owns the real property described on Exhibit A attached hereto and by this reference
made a part hereof (the "Parent Parcel"); and
WHEREAS, Landlord (or its predecessor -in -interest) and Tenant (or its predecessor -in -interest) entered into
that certain Land Lease Agreement dated March 24, 2000 (the "Original Lease") as amended by that certain
First Amendment to the Land Lease Agreement dated February 4, 2019 (the "First Amendment") (collectively,
the "Lease"), pursuant to which the Tenant leases a portion of the Parent Parcel and is the beneficiary of
certain easements for access and public utilities, all as more particularly described in the Lease (such portion
of the Parent Parcel so leased along with such portion of the Parent Parcel so affected, collectively, the
"Leased Premises"), which Leased Premises are also described on Exhibit A; and
WHEREAS, Landlord and Tenant desire to amend the terms of the Lease and to otherwise modify the Lease
as expressly provided herein.
NOW THEREFORE, in consideration of the foregoing recitals and the mutual covenants set forth herein and
other good and valuable consideration, the receipt, adequacy, and sufficiency of which are hereby
acknowledged, the Parties hereby agree as follows:
1. One -Time Payment. Tenant shall pay to Landlord a one-time payment in the amount of Ten thousand and
00/100 Dollars ($10,000.00), payable within thirty (30) days of the Effective Date and subject to the
following conditions precedent: (a) Tenant's receipt of this Amendment executed by Landlord, on or
before July 28, 2025; (b) Tenant's confirmation that Landlord's statements as further set forth in this
Amendment are true, accurate, and complete, including verification of Landlord's ownership; (c) Tenant's
receipt of any documents and other items reasonably requested by Tenant in order to effectuate the
transaction and payment contemplated herein; and (d) receipt by Tenant of an original Memorandum (as
defined herein) executed by Landlord.
2. Rent and Escalation. Commencing with the second rental payment due following the Effective Date, the
rent payable from Tenant to Landlord is hereby reduced to Two thousand five hundred and 00/100
Dollars ($2,500.00) per month (the "Rent'). Commencing on March 24, 2026 and on each successive
annual anniversary thereof, Rent due under the Lease, as amended hereby, shall increase by an amount
equal to two percent (2%) of the then current Rent. In the event of any overpayment of Rent prior to or
after the Effective Date, Tenant shall have the right to deduct from any future Rent payments an amount
equal to the overpayment amount. Notwithstanding anything to the contrary contained in the Lease, all
Rent and any other payments expressly required to be paid by Tenant to Landlord under the Lease and
this Amendment shall be paid to Town of Wappinger NY. The escalations in this Section shall be the only
escalations to the Rent and any/all rental escalations otherwise contained in the Lease are hereby null
and void and are of no further force and effect.
3. Counterparts. This Amendment may be executed in multiple counterparts, each of which when so
executed and delivered, shall be deemed an original and all of which, when taken together, shall constitute
one and the same instrument.
Site No: 373381 (DSE)
Site Name: Wappinger Falls
4. Conflict/Capitalized Terms. The Parties hereby acknowledge and agree that in the event of a conflict
between the terms and provisions of this Amendment and those contained in the Lease, the terms and
provisions of this Amendment shall control. Except as otherwise defined or expressly provided in this
Amendment, all capitalized terms used in this Amendment shall have the meanings or definitions ascribed
to them in the Lease. To the extent of any inconsistency in or conflict between the meaning, definition, or
usage of any capitalized terms in this Amendment and the meaning, definition, or usage of any such
capitalized terms or similar or analogous terms in the Lease, the meaning, definition, or usage of any such
capitalized terms in this Amendment shall control.
[SIGNATURES FOLLOW ON NEXT PAGE]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
IWil ►11101.1131
Town of Wappinger NY
Signature:
Print Name: Joseph D. Cavaccini
Title:
Date:
[SIGNATURES CONTINUE ON NEXT PAGE]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
TENANT:
ACC Tower Sub, LLC
a Delaware limited liability company
Signature: _
Print Name:
Title:
Date:
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXHIBIT A
This Exhibit A may be replaced at Tenant's option as described below.
IgilNa►kalel:1111141
Tenant shall have the right to replace this description with a description obtained from Landlord's deed (or
deeds) that include the land area encompassed by the Lease and Tenant's improvements thereon.
The Parent Parcel consists of the entire legal taxable lot owned by Landlord as described in a deed (or deeds) to
Landlord of which the Leased Premises is a part thereof with such Parent Parcel being described below.
BEGINNING at a point on the southerly side'of lfiddlebu'sh Road;
said point beiri the northwest corner of lands of Ganoselia =d "
the north least corner of the herein described parcel; thence
along the westerly and aoutherly lines of Caposella South 4
12' 45"" past 287.6 feet and Santh 88' 07"_55" East 125.00 feet;
theri along the -southerly line of'philips.and M-well.South 87"
08' IW' Bast '173.87 feet, thence along the westerly lines ofGaueli Acres South 2" 41' West 377.25 feet" South W 06" 20""
.West 139.41 feet, Sough 150 42' 50" West 1.4031 feet �v 'South 15"
1P
'08' 30" Bast 71.85 fest, South. 37" 11' East 66.40 feet„ South 9'
59' 30" 'hest 63.98 .feet and South 18' 15" 30" Vest 291.20 feet
theme along the northline of IDyaom South 52" 34' 20" West243.41 feet,: South 4.8" 30" West 75.46 femt, South 65' 15
4eat 33.93 feet and South 561 17' 25" !West 267.39 feet, thence
along the northerly and easterly line of Irvirm North 34" 01'
West 48"32 feet, North 32' 11' 30" Vlest 6+4,02 Toot, North 28'
39'.20" We at 217.25 feet, North 29" 54' 50'," Wert 200M feet,
Nort1t.32"29' 30" West 112. 51 feet, North 29° 3,8" 110„ Nest 163.46
feet, North 30'-55' West 516,80 feet. North 2.2" 18''10" Bast
322.19 feet and North 21' 05'•10" East 399.45 feet thence along
the southerly side of Middlebush Road South 85' 20' 50" Last
55.35 feet, North 83" 31" 40" li 357'_38 forret. South 81" 47':
10" Bast 16.51 feet, North 06' 56' 40"• East 215.13 feet and
North'.85° 41' ;aat 41.20 feet to the point or place of beginning..
.Contains 34.91 acres.
AN D:
809inrring at a pofugt, said point being at the southeastany coater of iands now or
forrnany Morns as shown on a map antltod, 'Subdivision Plot and. Property Line
Realtgnmantfrom Thomas & Eleanor Ssmmartfno to the Town of Wappinger"; an file in
the D7uicttass County Clark's Office as File dump, No. 11439, said posit also being on the
rmrtherfy line of Hopewell Road; thene9 ieaving said south6wtvdy corner and said
northerly read line and running along the eastarly line of. said Randa or Morse and the
easterly line of iands now or fonmaray 1-4y, the masterly One of lands now or formerly
Yanneralla; and the easterly line of tands now or formerly Ekstrosm; North 02' 31' 10"
East 047.07 feet to a. point being at the incehCeSteirly comer of said Ekstroem, said paint
also being on the aou0nerly Ifni of nti lends of the Town of Wappinger, Liber 1473.
Page 470, thence leaving said northeasterly scorner and punning ak"4V the southerly line
of said Town of Wappinger, North 44` 15',40" East 317.88 feat to a point being at the
southceaste0y canner of the Town 01`'4lfappinger; said point also being at the
suuthwestori corner of lands now or formerly Daises; thelace, ieavkV said common
comer and running along the southerly line of said 0stres and the southerly line of lands
ro"rrr or formerly Webb, the southerly line of lands now or formerly French., and the
soutlherlyline of lands now or fbirmerty, Ferraro, North 44' 15'410" East 079,96 feet to a
point being at the sou0nvestorly comer of lands now or formerly Ce ntrad Hudson Gas 8
Electric Corp.; thence ieaving said southerly limo of Ferraro and said southwesterly
cornsr and runnln,g along the sotbaniy line of said Central Hudson Gas i& Electric Corp.,
North 83' 44'30' East 167.93 feet W a point being on the northerly fine of lands now or
formerly Thomas Samir imo, Llbar M05, Page 2707 thence leaving said southerly" line
of Contrail Hudson Paas foMriu Corp. and running along the northerly line of said
Thcri Sammartino, South 00" 22" aft" East, 30,00 feet and South 44' 10' 40" 1Y11'est
680.09 feet to a palet being on the easterly One of lands now or fomAeriy Wappingas
Bdlble Fallmvship Church; thence leaving said northerly One of Thomas Sammartino and
running along the easterly, northerly and welAerly, Ones of said 4Wapio ngor Egli
Fellowship Church the folOow ing courses and dlstonmsr North 0i'46' 30" IEast,14.42
feet, South 44" 1 IS 4a'West 422.90 feet, and South 02' a't' '10" W11e9t 60894 deet to a
point being at the southwesterly COMer of said Wappinger Bible Fellowship Chiron" said
pool also being on the northerlyhRa of the afcm mentioned Old Hopewell Road; thence
leaving said southvrasterly corner and running along the norlherlY Ilne of sold road, iNorth
87'28'50' West 100,00 feet to the point of beginning containing 4-75 tz� acres of land,.
Being situated in the County of Dutchess, State of New York, and being known as
Dutchess County APN: 135689-6157-01-353724-0000.
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXHIBIT A (Continued)
LEASED PREMISES
Tenant shall have the right to replace this description with a description obtained from the Lease or from a
description obtained from an as -built survey conducted by Tenant.
The Leased Premises consists of that portion of the Parent Parcel as defined in the Lease which shall include
access and utilities easements. The square footage of the Leased Premises shall be the greater of: (i) the land
area conveyed to Tenant in the Lease; (ii) Tenant's (and Tenant's customers) existing improvements on the
Parent Parcel; or (iii) the legal description or depiction below (if any).
Commencing at a point located along the south line of Middlebush Road, said point of commencement being
the intersection formed by said south line of Middlebush Road with the division line between the lands now or
formerly of Dutchess County on the west and the lands now or formerly of the Town of Wappinger, a Municipal
Corporation (Instrument 02-2003-1647 & Book 1473, Page 470) on the east having a New York State Plane
Coordinate of Northing of 1,003,036.15 and an Easting of 650,850.23; thence from said point of commencement
and along said division line, and continuing along the lands now or formerly of Nature Preserve Homeowners
Association (Instrument 2010-4471), said line being along an existing stone wall, the following three courses: 1)
South 0902'30" West, 399.44 feet to a point ; 2) South 1015'30" West, 322.19 feet to a point and 3) South
4257'40" East, 96.34 feet to the point of beginning; thence from said point of beginning and through the
aforesaid lands of the lands of the Town of Wappinger the following three courses: 1) North 4702'20" East,
100.00 feet to a point; 2) South 4257'40" East, 100.00 feet to a point and 3) South 4702'20" West, 100.00 feet
to a point; thence along the first mentioned division line, North 4257'40" West, 100.00 feet to the point or
place of beginning;
Containing in all, 10,000 square feet of land or 0.23 acres, being the same more or less.
ACCESS AND UTILITIES
The access and utility easements include all easements of record as well that portion of the Parent Parcel
currently utilized by Tenant (and Tenant's customers) for ingress, egress and utility purposes from the Leased
Premises to and from a public right of way including but not limited to:
Access and Utility Easement No. 1:
Commencing at a point located along the south line of Middlebush Road, said point of commencement being
the intersection formed by said south line of Middlebush Road with the division line between the lands now or
formerly of Dutchess County on the west and the lands now or formerly of the Town of Wappinger, a Municipal
Corporation (Instrument 02-2003-1647 & Book 1473, Page 470) on the east having a New York State Plane
Coordinate of Northing of 1,003,036.15 and an Easting of 650,850.23; thence from said point of commencement
and along Middle Bush Road, North 8236'30" East, 55.35 feet and North 7129'00" East, 16.10 feet to a point;
thence through the aforesaid lands of the Town of Wappinger, South 3008'34" West, 46.57 feet to the point of
beginning; thence from said point of beginning and through the aforesaid lands of the Town of Wappinger, the
following sixteen courses: 1) South 5414'39" East, 15.13 feet to a point; 2) North 8334'18" East, 68.40 feet to a
point; 3) South 5814'41" East, 31.86 feet to a point; 4) South 1401'27" East, 127.11 feet to a point; 5) South
2812'58" West, 53.22 feet to a point; 6) South 4637'21" West, 66.14 feet to a point; 7) South 7746'07" West,
27.76 feet to a point; 8) North 8048'01" West, 67.24 feet to a point; 9) North 0900'09" East, 16.35 feet to a
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXHIBIT A (Continued)
ACCESS AND UTILITIES (Continued)
Access and Utility Easement No.1 (Continued):
point; 10) South 8038'38" East, 63.59 feet to a point; 11) North 7050'27" East, 27.76 feet to a point; 12) North
4437'54" East, 50.93 feet to a point; 13) North 2835'41" East, 25.19 feet to a point; 14) North 1401'27" West,
130.85 feet to a point; 15) South 8334'18" West, 93.92 feet to a point and 16) North 2006'37" East, 41.54 feet
to the point or place of beginning.
Containing in all 9,958 square feet of land or 0.229 acres, being the same more or less.
Access and Utility Easement No. 2:
Commencing at a point located along the south line of Middlebush Road, said point of commencement being
the intersection formed by said south line of Middlebush Road with the division line between the lands now or
formerly of Dutchess County on the west and the lands now or formerly of the Town of Wappinger, a Municipal
Corporation (Instrument 02-2003-1647 & Book 1473, Page 470) on the east having a New York State Plane
Coordinate of Northing of 1,003,036.15 and an Easting of 650,850.23; thence from said point of commencement
and along said Middlebush Road, North 8236'30" East, 15.77 feet to the point of beginning; thence from said
point of beginning and along Middle Bush Road, North 8236'30" East, 39.58 feet and North 7129'00" East,
16.10 feet to a point; thence through the aforesaid lands of the Town of Wappinger, the following nineteen
courses: 1) South 3008'34" West, 46.57 feet to a point; 2) South 2006'37" West, 41.54 feet to a point; 3) South
0824'51"West, 126.43 feet to a point; 4) South 1844'46" West, 21.99 feet to a point; 5) South 1415'54" East,
27.36 feet to a point; 6) South 8038'38" East, 7.15 feet to a point; 7) South 0900'09" West, 174.18 feet to a
point; 8) South 8041'28" East, 27.36 feet to a point; 9) South 1151'49" West, 249.22 feet to a point; 10) South
0021'55" West, 48.88 feet to a point; 11) South 3041'07" East, 37.72 feet to the above mentioned lease
parcel; 12) along the said lease parcel, South 4702'20" West, 40.39 feet to a point; 13) North 1807'35" West,
63.30 feet to a point; 14) North 0021'55" East, 51.51 feet to a point; 15) North 1022'20" East, 187.44 feet to a
point; 16) North 2039'19" West, 49.17 feet to a point; 17) North 1030'09" East, 194.18 feet to a point; 18)
North 1032'59" West, 46.61 feet to a point and 19) North 0944'12" East, 195.88 feet to the point or place of
beginning.
Containing in all 25,698 square feet of land or 0.590 acres, being the same more or less.
Site No: 373381 (DSE)
Site Name: Wappinger Falls
Instructions for completing the Resolution and Consent Affidavit
*IMPORTANT INFORMATION BELOW*
In order to avoid delays in the completion of this transaction, the Resolution and Consent
Affidavit must be signed by ALL Members, Partners, Directors, Shareholders, Officers or
Trustees of the organization. Section 6 of this form allows for the organization to appoint one
person to sign the remaining documents but ONE HUNDRED PERCENT (100%) of the ownership
or voting interest of the organization must sign this first. Failure to comply with these
instructions or properly indicate the percentage of ownership and/or voting interest will result
in delays and could require the documents to be re -executed. If you have any questions, please
contact your land lease representative.
Site No: 373381 (DSE)
Site Name: Wappinger Falls
Prepared by and Return to:
American Tower
10 Presidential Way
Woburn, MA 01801
Attn: Land Management/Nghia Trinh, Esq.
ATC Site No: 373381
ATC Site Name: Wappinger Falls
Assessor's Parcel No(s): 135689-6157-01-353724-0000
IN*161U1I[a]►Fill ►1IZIL•70MALIkrelyylpL\y/r1
Town of Wappinger NY
Be it known that, under the pains and penalties of perjury, the undersigned Members, Partners, Directors,
Shareholders, Officers or Trustees, as applicable (collectively, the "Affiants") of the above referenced entity
(the "Landlord"), hereby declare and resolve the following:
1. Landlord (or its predecessor -in -interest) has leased or subleased a portion of land to ACC Tower Sub,
LLC, a Delaware limited liability company (the "Tenant") under a Land Lease Agreement originally
dated March 24, 2000 (as the same may have been amended, renewed, extended, restated or
otherwise modified, collectively, the "Lease").
2. Landlord and Tenant desire to enter into an amendment of the Lease (the "Amendment") in order to
extend the term thereof and to further amend the Lease as more particularly set forth in the
Amendment, a copy of which is attached hereto as Exhibit A and by this reference made a part hereof.
Landlord is duly organized, validly existing, and in good standing in the jurisdiction of its formation,
organization, and/or incorporation, as applicable, and is otherwise authorized to transact business and
in good standing in any other jurisdictions where such qualifications are required. Landlord has full
power and authority to enter into and perform Landlord's obligations under the Amendment and the
other Transaction Documents (as hereinafter defined), and the Amendment and the other Transaction
Documents have been duly executed and delivered by Landlord. The Affiants listed below are the only
legal and equitable owners of Landlord and are the only members, partners, directors, shareholders,
officers and/or trustees, as applicable, of Landlord.
4. The Affiants hereby approve of the Transaction Documents and all of the terms and provisions
contained therein and declare, resolve and/or affirm, as applicable, that Landlord is hereby authorized
to enter into the Transaction Documents with Tenant and effect the transactions contemplated
therein. The Affiants hereby declare and affirm that any other corporate and shareholder, member,
Site No: 373381 (DSE)
Site Name: Wappinger Falls
partner, and/or trustee actions required to effectuate the transactions contemplated in the
Amendment and other Transaction Documents have been completed.
5. The Affiants also declare that they have full legal authority to bind Landlord under the laws of the
State or Commonwealth in which the Leased Premises (as defined in the Amendment) is located, and
Affiants have the full authority to execute any and all of the Transaction Documents on behalf of
Landlord and to nominate individuals to act on Landlord's behalf.
6. The Affiants hereby nominate the below listed individual (the "Nominee") as attorney-in-fact to
execute and deliver the Amendment, together with any other documents and agreements, including,
without limitation, the Memorandum (as defined in the Amendment), required to be executed and
delivered pursuant to the terms and provisions of the Amendment (the Amendment and all of such
other aforementioned agreements and documents, collectively, the "Transaction Documents"), on
behalf of Affiants and Landlord. The Nominee shall have full power and authority to act on behalf of
Affiants and on behalf of Landlord for purposes of executing and delivering the Transaction
Documents and ensuring that Landlord fulfills its obligations thereunder. Additionally, the Nominee
shall have full authority to direct the manner in which all payments made by Tenant pursuant to the
Amendment are to be made to Landlord, including, without limitation, identifying which bank
account(s) to transfer funds to in the event a wire payment is made by Tenant.
NOMINEE: (Print Name)
(Address)
7. This Resolution and Consent Affidavit shall become effective as of the date of the last notarized
signature of the Affiants listed below.
8. Affiants hereby acknowledge and agree that Tenant, its lenders, and its title insurance company are
relying upon, and are entitled to rely upon, this Resolution and Consent Affidavit and the contents
hereof as a material inducement to entering into the Amendment and other Transaction Documents.
Tenant, its lenders, and its title insurance company may rely upon a faxed, scanned or otherwise
electronically reproduced fully -executed copy of this document as if it were an original.
9. This document can only be amended or modified by addendum or an amendment that is fully
executed and notarized by all Affiants listed hereunder.
[SIGNATURE AND NOTARY PAGES TO FOLLOW]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO. 1
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202_, before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO. 2
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202. before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO. 3
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202_, before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO.4
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202_, before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO. 5
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202_, before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
Site No: 373381 (DSE)
Site Name: Wappinger Falls
EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW
AFFIANT NO. 6
Signature: _
Print Name:
Date:
WITNESS
Signature: _
Print Name:
Title: (circle one) Member, Partner, Director, Shareholder, Officer, Trustee
Percentage Ownership or Voting Interest: % Signature: _
Print Name:
WITNESS AND ACKNOWLEDGEMENT
State/Commonwealth of
County of
On this day of 202_, before me, the undersigned Notary Public,
personally appeared -'personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity
upon which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
Print Name:
My commission expires:
[SEAL]
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