Form Rp-524 - Complaint On Real Property Assessment
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2)
NYS DEPARTMENT OF TAXATION & FINANCE - OFFICE OF REAL PROPERTY TAX SERVICES
RP-524 (3/09
COMPLAINT ON REAL PROPERTY ASSESSMENT FOR 20______
PART FOUR: DESIGNATION OF REPRESENTATIVE TO MAKE COMPLAINT
BEFORE THE BOARD OF ASSESSMENT REVIEW FOR ____________________________________
(city, town village or county)
I, __________________________________________________, as complainant (or officer thereof) hereby desig-
nate_____________________________________________________ to act as my representative in any and all proceedings
PART ONE: GENERAL INFORMATION
before the board of assessment review of the city/town/village/county of ____________________ for purposes of reviewing
the assessment of my real property as it appears on the _____(year) tentative assessment roll of such assessing unit.
(General information and instructions for completing this form are contained in form RP-524-Ins)
_________________________________
__________________________________
1. Name and telephone no. of owner(s)
2. Mailing Address of owner(s)
Date
Signature of owner (or officer thereof)
PART FIVE: CERTIFICATION
__________________________________________________
_________________________________________________
I certify that all statements made on this application are true and correct to be best of my knowledge and belief, and I under-
__________________________________________________
_________________________________________________
stand that the making of any willful false statement of material fact herein will subject me to the provisions of the Penal Law
relevant to the making and filing of false instruments.
Day no. (
)___________________________________
_________________________________________________
_________________________________
__________________________________
Email (optional)___________________________________
Evening no. (
)________________________________
Date
Signature of owner (or representative)
PART SIX: STIPULATION
3.
Name, address and telephone no. of representative of owner, if representative is filing application.
The complainant (or complainant’s representative) and assessor (or assessor designated by a majority of the board of asses-
(if applicable, complete Part Four on page 4.)
sors) whose signatures appear below stipulate that the following assessed value is to be applied to the above described prop-
____________________________________________________________________________________________
erty on the ____(year) assessment roll: Land $_____
Total $_____
(Check box if stipulation approves exemption indicated in Part Three, section B.2. or C.1.)
____________________________________________________________________________________________
______________________________
___________________________
_________
4.
Property location
Complainant or representative
Assessor
Date
SPACE BELOW FOR USE OF BOARD OF ASSESSMENT REVIEW
____________________________________
_______________________________________
Street Address
Village (if any)
Disposition
Unequal assessment
Excessive assessment
_________________________________
____________________________________
Unlawful assessment
Misclassification
City/Town
County
Ratification of stipulated assessment
No change in assessment
_______________________________________
School District
Reason: _____________________________________________________________________________________
5.
Property identification (see tax bill or assessment roll)
____________________________________________________________________________________________
Vote on Complaint
Tax map number or section/block/lot _________________________________________________
All concur
All concur except: _______________________
against
abstain
absent
Type of property:
Residence ______
Farm _______
Vacant land ________
Name
_______________________
against
abstain
absent
Commercial _____
Industrial ________
Other ______________
Name
Description: _____________________________________________________________________________
Decision by
Tentative assessment
Claimed assessment
Board of Assessment Review
____________________________________________________________________________________________
Total assessment
$________________
$_________________
$_________________________
Transition assessment (if any) ....... $________________
$_________________
$_________________________
Assessed value appearing on the assessment roll:
Exempt amount .............................. $________________
$_________________
$_________________________
Taxable assessment ........................ $_________________
$_________________
$_________________________
6.
Land $____________
Total $________________
Class designation and allocation of assessed value (if any):
7.
Property owner’s estimate of market value of property as of valuation date (see instructions) $_________
Homestead ..................................... $________________
$_________________
$_________________________
Non-homestead ............................. $________________
$_________________
$__________________________
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