Form Tc150 - Supplemental Application - 2011
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1TAX COMMISSION OF THE CITY OF NEW YORK
1 Centre Street, Room 936, New York, NY 10007
TC150
2011
SUPPLEMENTAL APPLICATION
INSTRUCTIONS: Use this form to submit a supplemental application, from March 2 to March 24, inclusive, for one of the purposes listed.
This submission is for attachment to an application identified as follows:
BOROUGH (Bronx, Brooklyn, Manhattan, Queens or Staten Island)
BLOCK
LOT
ASSESSMENT YEAR
2011/12
APPLICANT NAME
REPRESENTATIVE
GROUP #, IF ANY
PURPOSE OF THIS SUBMISSION – Check the applicable box.
Rental property having an actual assessment of $750,000 or more. The original application did not include a complete
statement of income and expenses. Attach an income and expense schedule on Form TC201 and, if the actual assessment is
$1,000,000 or more, and income exceeds $100,000, an accountant’s certification on Form TC309.
Other income-producing property having an actual assessment of $750,000 or more. The original application did not
include a complete statement of income and expenses on the appropriate Tax Commission form for a hotel, department store,
theatre, parking garage or lot, cooperative or condominium. Attach Form TC208, TC214 or TC203.
Form TC200, Part 5. Lease information that was not filed with the original application (actual assessment of $750,000 or
more). Is attached
Rental property having an actual assessment of less than $750,000. The original application did not include a complete
statement of income and expenses, the applicant uses a calendar year for federal tax purposes and acquired the property from an
unrelated person more than six months but less than twenty-four months before the beginning of this calendar year. Complete
Form TC201 for the calendar year or shorter period of ownership ending December 31 and file it with this form. Also attach the
Tax Commission’s Sale Schedule, Form TC230 and a copy of the closing statement.
ATTACHMENTS - List all schedules and documents attached.
Attachment
Number of pages
_________________________________________________________________
________________________
_________________________________________________________________
________________________
_________________________________________________________________
________________________
Total pages attached
_________________
OATH
The oath must be signed by the applicant, a fiduciary, an officer of a corporate applicant, or an agent who has personal
knowledge of the facts and the applicant’s power of attorney. The applicant must be the owner or other person aggrieved by the
assessment. The submission of materially false or misleading information is a crime.
Print name of person signing ____________________________________________________________
If signing as corporate officer, you must specify name of corporation and officer’s title:
Name of corporation __________________________________________________________ Title _________________________
Signer or corporation is: The applicant
General partner of partnership applicant.
Member or manager of limited liability
company (LLC) applicant. Fiduciary (specify) __________________________________________________________________
th
An attorney, employee, manager or other agent (A notarized power of attorney and Form TC244 must be attached); file on 9
floor
CERTIFICATION: I certify that all statements made on this supplemental application, including the
attached sheet(s) totaling _____ pages, are true and correct to the best of my knowledge and
belief, and I understand that such statements are subject to verification. I also understand that
the making of any willful false statement of material fact in this application including the attached
sheet(s) will subject me to the provisions of the penal law relevant to the making and filing of
false statements.
Signature of affiant:
_________________________________________Date_________________
Sworn to before me
County
State
Date
____________________
__________
__________
Signature of person administering oath:
DATE RECEIVED
__________________________________________________________
NOTARY STAMP
The signer must appear and acknowledge the signature before a notary.
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