Form Tc106ins - Application For Correction Of Assessment On Grounds Other Than, Or In Addition To, Overvaluation, Including Claims Of Exemption Or Classification - 2009 Page 5

– Complete this part unless you claim only total exemption or unlawfulness.

8. VALUATION CLAIM

The class assessment ratios used by the Department of Finance are 6% for tax class 1 and 45% for tax classes 2, 3 and 4.

Property as a whole

Taxable portion

Tentative actual assessment

$ ____________________

Applicant's estimate of market value

$ ____________________

Requested assessment = line b x 6% or 45% assessment ratio

$ ____________________

Market value of land as if unimproved (if relevant)

$ ____________________

Market value added by construction or alteration during past two years

$ ____________________

The applicant reserves the right to allege an assessment ratio lower than 6% for tax class 1 or 45% for tax class 2, 3 or 4 and seek a lower assessment in a

proceeding for judicial review of the assessment the applicant may commence.

Information in support of market value estimate _______________________________________________________________________________________

9. PROPERTY DESCRIPTION AS OF JANUARY 5, 2009 – Property uses; retail units, dwellings, vehicle parking spaces.

NUMBER OF BUILDINGS

NUMBER OF STORIES ABOVE GRADE

YEAR OF CONSTRUCTION

NUMBER OF DWELLING UNITS

NUMBER OF RETAIL UNITS

NUMBER OF VEHICLE PARKING SPACES

Indoor:

Outdoor:

______________

________________

YEAR OF PURCHASE

NUMBER OF VEHICLE PARKING SPACES PAID

Indoor: ___________

Outdoor: ____________

USES (residential, office, retail, hotel, loft, factory, warehouse, storage, garage, theatre, etc.).

FLOORS 3

-___

________________________________________________________________________________________________________________________________________

SECOND FLOORS

________________________________________________________________________________________________________________________________________

FIRST FLOOR

BASEMENT

________________________________________________________________________________________________________________________________________

OUTDOOR SPACE

________________________________________________________________________________________________________________________________________

Does the building have a certificate of occupancy? _____. If yes, attach a copy.

10. APPROXIMATE GROSS FLOOR AREA AS OF JANUARY 5, 2009

Floor

All uses (above grade)

Retail

Garage

Offices

sq.ft.

FLOOR 3 - __

sq.ft.

SECOND FLOOR

sq.ft.

FIRST FLOOR

sq.ft.

BASEMENTS

sq.ft.

TOTAL AREA

11. OATH

BOROUGH

BLOCK

LOT

This application must be signed by an individual having personal knowledge of the facts who is the applicant or a fiduciary or an agent or an officer of a

corporation or a general partner of a partnership or a member or manager of a limited liability company, which legal entity is the applicant or is a general partner

or member or manager of the applicant. If an agent signs, attach a notarized power of attorney signed by the applicant and Tax Commission Form TC244,

Agent's Statement of Authority and Knowledge. If a fiduciary, see Form TC600 for instructions on documentation of authority.

Print name of person signing ___________________________________ If signing as an officer, general partner or member or manager, specify name of entity

and person’s title.

Name of entity __________________________________________________________ Title _____________________________________________

Signer or entity is:

The applicant

General partner of partnership applicant

Member or manager of limited liability company applicant

An attorney, employee, property manager or other agent. A notarized power of attorney and Form TC244, Agent's Statement must be attached.

If signing as fiduciary and applicant is a corporation, partnership, or LLC entity, specify name of entity and name and title of person for whom you are signing.

Name of entity ________________________________________

Name and title _____________________________________________________

I, the person whose signature appears below, swear or affirm under penalty of perjury that the statements contained in this application, including

attachments, are true to my personal knowledge, and understand that such information is subject to verification.

Signed: _________________________________________________________________________________

The signer must appear and acknowledge the signature before a notary.

County __________________________ State ___________________________ Date _________________

Sworn to before me:

NOTARY STAMP

Signature of person administering oath ________________________________________________________

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TC106