Lorraine, NY · Jefferson County
Statement of Disclosure of Interest
This three-page statement discloses relationships between people or entities interested in property and government officers or employees, and is signed by owners or purchasers filing a property application.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Lorraine Form #18 asks property owners and people or entities with a contract to purchase an interest in the subject property to disclose specified connections to state, county or town government officers or employees. Signers complete Part I statements or explain any that are untrue in Part II. The form is used for an application concerning the property and includes an acknowledgment for the applicant’s signature.
Who needs it
Each individual property owner or purchaser with an interest, and an authorized representative of each entity with an ownership or purchase-contract interest, must sign.
Why it needs a notary
The form carries an acknowledgment, which each required applicant or authorized entity representative must sign before a notary.
How to get this notarized
- 1
Download The Form
Get Lorraine Form #18, Statement of Disclosure of Interest.
- 2
Review And Complete
Review Parts I and II and provide the required applicant and property-interest information.
- 3
Book An Online Notary
Schedule a remote notarization with Rush Notary.
- 4
Sign On Video
Sign the acknowledgment during your online notary session.
- 5
Submit To The Town
Follow the Town of Lorraine application instructions to submit the completed form.
Preview the form
The blank PDF straight from Lorraine. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the Statement of Disclosure of Interest?
- Review the statements about property owners, purchasers, entities and their relationships to government officers or employees. Explain any statement that is not true, then sign the acknowledgment before a notary.
- Do I need to notarize this disclosure?
- Yes. The form includes an acknowledgment on page 3. The required individual applicant or authorized representative signs before a notary.
- Can I notarize the form online?
- New York authorizes remote online notarization for its own notaries under Executive Law §135-c, effective in 2023. A commissioned online notary can guide you through signing on video.
- Where do I submit the signed form?
- The form is for an application concerning property in the Town of Lorraine. Follow the application instructions; confirm with the city, town or village if unsure.