Property Owner'S Registration Form - New York Department Of Finance
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1FOR OFFICE USE ONLY
PROPERTY OWNER'S REGISTRATION FORM
F I N A N C E
NEW YORK
THE CITY OF NEW YORK
DEPARTMENT OF FINANCE
NEW YORK CITY DEPARTMENT OF FINANCE CENTRAL REGISTRATION 59 MAIDEN LANE, 20TH FLOOR, NEW YORK, NY 10038
ONLY ONE (1) PROPERTY (BLOCK AND LOT) MAY BE REGISTERED WITH THIS CARD. MAKE PHOTOCOPIES IF YOU ARE REGISTERING MORE THAN ONE PROPERTY.
Ty p e o r p r i n t i n i n k .
A d d i t i o n a l i n s t r u c t i o n s a p p e a r o n t h e r e v e r s e s i d e o f t h i s f o r m .
PROPERTY OWNER'S INFORMATION
B I L L I N G I N F O R M AT I O N - S P E C I A L A S S E S S M E N T B I L L S
(FOR GENERAL CORRESPONDENCE)
INDICATE TO WHOM SPECIAL ASSESSMENT BILLS SHOULD BE MAILED. (SEE INSTRUCTIONS FOR LINE 10)
Borough the property is in:________________, Block:
Lot:
1.
10.
TYPE OF SPECIAL ASSESSMENT BILL:
Owner's name - FILL EITHER 2A OR 2B ONLY
Name of Recipient
2a.
Individual Owner
.
.
FIRST
M
I
LAST
Address
2b.
Business Owner
City
State
Zip Code
3.
Owner's Residence or Company's Business Address
City
State
Zip Code
Relationship of addressee to property
(Check
one)
Owner
Tenant
Agent
4.
Property Address
If "TENANT" is checked provide either Social Security Number or Employer Identification Number,
City
State
Zip Code
whichever is applicable.
SOCIAL SECURITY NUMBER
EMPLOYER IDENTIFICATION NUMBER
5.
If the property has more than one owner, check this box and see instructions -
6.
Owner's Tax Identification Number -
TYPE OF SPECIAL ASSESSMENT BILL:
OR
SSN (If owner is an individual or trust)
EIN (If owner is a corporation or partnership)
Name of Recipient
Address
City
State
Zip Code
7. Indicate owner's daytime telephone number: (_________) ________________________
Relationship of addressee to property
(Check
one)
B I L L I N G I N F O R M AT I O N - R E A L E S TAT E TA X B I L L S
IF YOUR MORTGAGE PAYMENTS INCLUDE YOUR REAL ESTATE TAXES, FILL IN THE NAME AND ADDRESS OF YOUR BANK/LENDER IN THE SPACE
Owner
Tenant
Agent
PROVIDED IN 9 BELOW. IF NOT, FILL IN THE NAME AND ADDRESS TO WHICH YOU ARE CHOOSING TO HAVE REAL ESTATE TAX BILLS SENT.
If "TENANT" is checked provide either Social Security Number or Employer Identification Number,
whichever is applicable.
8.
Indicate to whom Real Estate Tax bills should be mailed
(Check
one)
SOCIAL SECURITY NUMBER
EMPLOYER IDENTIFICATION NUMBER
Bank/Lender
Owner
Tenant
Agent
If "TENANT" or "AGENT" is checked provide either Social Security Number or Employer Identification Number, whichever is applicable.
11.
Signature of owner or corporate officer
12.
Date
(required by statute)
SOCIAL SECURITY NUMBER
EMPLOYER IDENTIFICATION NUMBER
OR
________________________________________________
_______/_______/_______
9.
If you need assistance in completing this form, please call Customer
Name of Real Estate Tax Bill Recipient
Assistance at 212-504-4080
Si usted necesita recibir asistencia en
Address
Español para llenar esto formulario, llame al 212-504-4080 y solicite un
Representante que hable Español.
City
State
Zip Code
NOTE: Water and Sewer Charge registration requires a different form.
Contact the Bureau of Water and Energy Conservation at (718) 595-7000.
Have you recently paid off your mortgage? ( )
Yes
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