Form Rp-425-Biv - Basic Star Exemption Eligibility Determination
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1We need your social security number to determine your eligibility for the
Basic STAR exemption in future years.
In order to receive the Basic STAR property tax exemption, the total income of all owners and their
spouses who reside at the property must be $500,000 or less.
To determine your household income, the Tax Department needs the social security numbers of all
owners and owners’ spouses who reside at the property.
• By providing social security numbers to the assessor, you authorize the Tax Department to verify
your Basic STAR eligibility for future years. If you don’t provide the numbers, you’ll have to provide
income information to your assessor each year in order to receive the STAR exemption.
• The assessor will not keep a record of the social security numbers.
• The Tax Department will not disclose your income to the assessor. It will only inform the assessor
whether you qualify for the exemption. When the Tax Department can’t determine eligibility, the
assessor will ask you to provide income information.
LOCATION OF PROPERTY
___________________________________
____________________
__________________
Street address, City/Town
Village
School district
Tax map number or section/block/lot:
(see tax bill or assessment roll)
________________________________________________
AUTHORIZATION
The undersigned authorize the New York State Tax Department to annually verify, using the social security
numbers supplied below, their eligibility for the Basic STAR real property tax exemption.
Please Print
Social Security
First Name
M.I.
Last Name
Number
Signature
1
2
3
Important: This authorization must be signed by all of the owners who reside on the property, and by any
owner’s spouse who resides on the premises. Attach additional sheets if necessary.
PLEASE RETURN THIS FORM TO YOUR ASSESSOR
United States Privacy Act Notification
Section 425(3) of the New York State Real Property Tax Law authorizes us to ask for your social security
numbers. You are not required to provide them to the assessor. If you do provide the numbers, the
assessor will forward them to the New York State Tax Department, which will use them to verify that your
income qualifies you for the Basic STAR real property tax exemption. If you do not provide your Social
Security Numbers, you will be required to provide a copy of your tax returns to your assessor in future
years.
RP-425-BIV (2/11)
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Parent category: Financial