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Form Rp-421-F - Application For Real Property Tax Exemption For Capital Improvements To Residential Property - 1995

NYS BOARD OF REAL PROPERTY SERVICES

RP-421-f (1/95)

16 Sheridan Avenue, Albany, NY 12210-2714

APPLICATION FOR REAL PROPERTY TAX EXEMPTION FOR CAPITAL

IMPROVEMENTS TO RESIDENTIAL PROPERTY

(Real Property Tax Law, Section 421-f)

(Instructions for completing this form are contained in Form RP-421-f-Ins)

l. Name and telephone no. of owner(s)

2. Mailing address of owner(s)

__________________________________

____________________________________

__________________________________

Day No. ( )_______________________

Evening No. ( )____________________

____________________________________

3. Location of property (see instructions)

___________________________________

____________________________________

Street Address

School District

___________________________________

_____________________________________

City/Town

Village (if any)

Property identification (see tax bill or assessment roll)

Tax map number or section/block/lot ________________________________________________

4. Property for which exemption is sought is a ___one family/___two family residence. (check one)

5. a. Square footage of residence without improvement________square feet

b. Square footage of residence with improvement_________square feet

c. As measured by square footage in question 5b, is more than one-half of the residence

at least five years old?

___yes

___no

6. a. Date of commencement of construction of improvement ____________

b. Date completed (attach copy of certification of occupancy or other documentation of

completion) ________________

7. Describe the improvement for which exemption is sought (attach additional sheets if

necessary).

________________________________________________________________________

8. Cost of improvement: $______________ (supply documentation)

Form Rp-421-F - Application For Real Property Tax Exemption For Capital Improvements To Residential Property - 1995