E X C E S S S C R I E R E F U N D
APPLICATION FOR REIMBURSEMENT OR TRANSFER OF EXCESS SENIOR
CITIZEN RENT INCREASE EXEMPTION (SCRIE) TAX ABATEMENT CREDITS
F I N A N C E
NEW YORK
T Y P E
O R
P R I N T
,
( )
REASON FOR REFUND OR TRANSFER OF CREDIT
CHECK
ONE OR MORE
AS APPROPRIATE
EXCESS SCRIE CREDITS APPLIED
UNUSED PAPER
PARTIALLY USED PAPER
1
TO YOUR REAL ESTATE TAX ACCOUNT
SCRIE CERTIFICATES
SCRIE CERTIFICATES
(Submit original tax abatement certificate)
INDICATE REAL ESTATE TAX YEAR WHEN
SCRIE WAS CREDITED
YEAR ENDING JUNE 30,
_________
,
INDICATE THE BOROUGH
BLOCK AND LOT FOR
CURRENT OWNER'S NAME
WHICH TAX ABATEMENT CERTIFICATE IS ISSUED
2
BOROUGH
BLOCK
LOT
C/O ATTORNEY OR AGENT, IF APPLICABLE
3
OWNER'S EMPLOYER IDENTIFICATION NUMBER
MAILING ADDRESS (NUMBER AND STREET)
(
)
IF CORPORATION OR PARTNERSHIP
CITY AND STATE
ZIP CODE
4
OWNER'S SOCIAL SECURITY NUMBER
(
)
IF INDIVIDUAL
$
A. TOTAL AMOUNT OF EXCESS SCRIE PAPER CERTIFICATES ATTACHED
....................................................................................................
$
B. TOTAL AMOUNT OF EXCESS SCRIE CREDITS CURRENTLY APPLIED TO YOUR REAL ESTATE TAX ACCOUNT
..........
$
C. ADD LINES A AND B
....................................................................................................................................................................................................
$
D. AMOUNT TO BE REFUNDED ..........................................................................................................................................................
E. AMOUNT TO BE CREDITED TO REAL ESTATE TAX PERIODS IN EARLIER YEARS, CURRENT YEAR OR NEXT
$
FISCAL YEAR FOR THE SAME PROPERTY..................................................................................................................................
INDICATE THE PERIOD(S) TO WHICH THE CREDIT IS TO BE TRANSFERRED:
5
7-1-_____
$____________
10-1-_____
$____________
1-1-_____
$____________
4-1-_____
$_____________
F. AMOUNT TO BE CREDITED TO REAL ESTATE TAX PERIODS IN EARLIER YEARS, CURRENT YEAR OR NEXT
$
FISCAL YEAR FOR ANOTHER PROPERTY THAT YOU OWN. ..................................................................................................
INDICATE BOROUGH, BLOCK AND LOT_____________________________________________________________________,
INDICATE THE PERIOD(S) TO WHICH THE CREDIT IS TO BE TRANSFERRED:
7-1-_____
$____________
10-1-_____
$____________
1-1-_____
$____________
4-1-_____
$_____________
(Sum of amounts to be refunded and transferred should total amount on line C.)
F O R
O F F I C I A L
U S E
O N L Y
DESCRIPTION
CLAIM NUMBER
NAME OF EXAMINER
R E F U N D
O F
O R
T R A N S F E R
O F
S C R I E
DATE EXAMINED
TOTAL AMOUNT OF OVERPAYMENT
.......
NAME OF REVIEWER
TOTAL AMOUNT OF REFUND
.......................
DATE REVIEWED
TOTAL AMOUNT OF TRANSFER
.................