Form Tc101 - Application For Correction Of Assessed Value Of A Parcel - 2005 Page 2

7. SALE OR CONSTRUCTION AFTER JANUARY 5, 2003 - You must answer both questions.

Has the property or an interest in it been bought, sold, transferred or placed under contract of sale? _____. If yes, submit Form TC230. If transferred

between related parties, Form TC200 may be submitted instead.

Has any construction or major alteration work been done or is a new building proposed in filed plans? _____. If yes, submit Form TC200.

8. PROPERTY DESCRIPTION AS OF JANUARY 5, 2005 – Property uses; units (retail, dwellings, vehicle parking)

NUMBER OF BUILDINGS

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, theater, etc.).

FLOORS 3

-___

_________________________________________________________________________________________________________________________________

SECOND FLOOR

_________________________________________________________________________________________________________________________________

FIRST FLOOR

BASEMENTS

_________________________________________________________________________________________________________________________________

OUTDOOR SPACE

_________________________________________________________________________________________________________________________________

9. APPROXIMATE GROSS FLOOR AREA AS OF JANUARY 5, 2005

Floor

All uses (above grade)

Retail

Garage

Offices

sq.ft.

FLOORS 3-___

sq.ft.

SECOND FLOOR

sq.ft.

FIRST FLOOR

sq.ft.

BASEMENTS

sq.ft.

TOTAL AREA

10. USE BY APPLICANT

On January 5, 2005, was any of the property used by the applicant or related persons? _______. If yes, complete Part 10.

Use by applicant:

Entire property.

Part. Specify location in building ___________________________________________________________

Approximate nonresidential gross floor area used by applicant _______________ sq.ft., of which first floor ______________, basement ____________

Describe applicant's use ______________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

See instructions if used as a department store, public parking garage or lot, theater or hotel.

BOROUGH

BLOCK

LOT

11. OATH

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.

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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TC101