Form Rp-552 - Verified Statement Of Assessor To Board Of Assessment Review - 2006
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2RP-552 (1/06)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICE
VERIFIED STATEMENT OF ASSESSOR TO BOARD OF ASSESSMENT
REVIEW FOR THE _____________________________ FOR THE
Assessing Unit
CORRECTION OF THE 20 _____ TENTATIVE ASSESSMENT ROLL
(Instructions and general information on back)
To be completed in duplicate by the assessor or a designated member of the Board of Assessors. One copy of this is to be transmitted to the
individual named in item 1. Transmit original to Board of Assessment Review. This statement is valid solely for corrections to tentative
assessment rolls. It is not to be used after delivery of the verified list of changes by the Board of Assessment Review to the assessor(s).
Day (
)
Evening (
)
1a. Name of Owner
2. Telephone Number
1b. Mailing Address
3. Parcel Location (if different than 1b.)
1c. E-mail Address (optional)
4. Description of real property as shown on tax roll or tax bill (include tax map designation)________________________________
_________________________________________________________________________________________________________________
5. Account No. _________________________________________
6a. Entry appearing on tentative assessment roll:
6b. Entry on tentative assessment roll should be:
Land Value__________________________
Land Value______________________________
Total Value__________________________
Total Value______________________________
Exempt Value________________________
Exempt Value____________________________
7. Reason for correction (see definitions on reverse)
________ Clerical Error as defined in Sec. 550(2) para. ______
________ Error in Essential Fact as defined in Sec. 550(3) para._______
(include a copy of the property record card, field book or other
final work product and a copy of a municipal record
substantiating the occurrence of the error.)
________ Unlawful Entry as defined in Sec. 550(7) para. _____
________ Late senior citizen exemption renewal application, pursuant to
Sec. 467(8).
8. Describe how error occurred. (Be specific; do not repeat definition on reverse side; attach documentation to support correction).
VERIFICATION BY ASSESSOR
____________________________________, Assessor or designated member of the Board of Assessors of the ________________________
(City/Town/Village)
of
___________________________________
being duly sworn, says that the assessment for the real property described above appearing on
the tentative assessment roll for the city, town, or village of ___________________________________ is in error due to a *clerical error,
error in essential fact, unlawful entry, or a late senior citizen exemption renewal application.
_________________________________________
Assessor’s signature
Sworn to before me this
________day of ______________20_________
______________________________________
(*circle type of error)
Notary Public
Remarks: ________________________________________________________________________________________________________
To be completed by
Board of Assessment Review
Final approval assessment (include on verified list of changes)……………………………….$______________________________________
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