Senior Citizen Rent Increase Exemption (Scrie) Disability Rent Increase Exemption (Drie) Transfer Application Form

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NYC DEPARTMENT oF FINANCE
PRogRAM oPERATIoNS DIVISIoN
FoR oFFICE uSE oNlY
SENIOR CITIZEN RENT INCREASE EXEMPTION (SCRIE) < - >
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DISABILITY RENT INCREASE EXEMPTION (DRIE)
Finance
TRANSFER APPLICATION
Please mail this completed application with all required documents to:
NYC Department of Finance - SCRIE Unit, 59 Maiden Lane, 22nd Floor, New York, NY 10038
SECTION 1 - GENERAL APPLICATION INFORMATION
Use this application to transfer from DRIE to SCRIE or from SCRIE to DRIE. This application must be submitted at least
(60) days before the lease or rental agreement’s expiration date to ensure there is no lapse in your benefit coverage.
You may want transfer from DRIE to SCRIE if you are now 62 years old. Please be aware there is nothing in the law
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that requires someone who has DRIE to apply for SCRIE at age 62.
You may want to transfer to SCRIE, if you are a surviving family member, spouse, or domestic partner of a recently
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deceased DRIE beneficiary who meets the age requirement of 62 for SCRIE, but not the disability requirement for
DRIE. Please note that you must have been listed as a household member on the beneficiary’s DRIE application.
You may want to transfer to DRIE, if you are a surviving family member, spouse, or domestic partner of a recently
deceased SCRIE beneficiary who is less than 62 years of age with a qualifying federal disability benefit. Please note
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that you must have been listed as a household member on the beneficiary’s SCRIE application.
To qualify for SCRIE, the total household income for the prior calendar year must be $50,000 or less.
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To qualify for DRIE, the total household income for the prior calendar year must be $50,000 or less.
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For DRIE, you must be receiving Supplemental Security Income (SSI), Social Security Disability Income (SSDI), VA
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Disability Pension, VA Compensation or Disability-related Medicated at the time of the transfer. If you are not cur-
rently receiving any of the above disability benefits when filing for the transfer, you will not be eligible for DRIE.
If you are approved for a transfer to SCRIE or to DRIE, in most cases the SCRIE or DRIE frozen rent will not change
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and will remain the same once you have transferred.
SECTION 2 - TRANSFER APPLICANT INFORMATION
1. If you would like to transfer the current benefit from DRIE to SCRIE, enter DRIE ID number: ___________________
2. If you would like to transfer the current benefit from SCRIE to DRIE, enter SCRIE docket number: ___________________
3. Applicant
Name: ______________________________________________________________________________________
FIRST
lAST
4. Address:
__________________________________________________________________ Apt. #:
_________________
NuMbER
STREET NAME
City: _______________________________________________________ Zip Code: ______________________
5. Social Security
6. Date of
Number: ___________________________________________________
birth: ________________________
MoNTh / DAY / YEAR
7. Name of DRIE or SCRIE
8. Date of Death
beneficiary (if applicable): ______________________________________
(if applicable): _________________
MoNTh / DAY / YEAR
9. Relationship to DRIE or SCRIE
beneficiary (if applicable): __________________________
SECTION 3 - TENANT REPRESENTATIVE
You can have copies of your notices sent to another person (in addition to you). If you would like to add a representative, please complete the following:
1. Name of
2. Email
Representative: _________________________________________
Address:____________________________
3. Address: ______________ 4. _______________________________________________ 5. Apt. #: _________
Zip
NuMbER
STREET NAME
6. City: _________________________ 7. Code: _____________ 8. Telephone (_____) _____________________
Visit Finance at nyc.gov/finance
SCRIE < - > DRIE Appl. Rev. 05.07.2015

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