Form Rp-3611 - Attainment Aid - Payment # 3
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1
2New York State
Office of Real Property Services
ATTAINMENT AID - PAYMENT # 3
Application requesting a Review for the Completion of a Plan for Data Collection.
Submitted By: Name, Title
Contact Person's Name and Title
____________________________________________________________________________________________________________________
City, Town or County
Address
___________________________________________________________________________________________________________________
Address
Zip Code
____________________________________________________________________________________________________________________
Zip Code
Phone Number
*********************************************************************************************************************************
INSTRUCTIONS:
The request for review may be made by an assessing unit (excluding village assessing units) or, where a
county is acting on behalf of an assessing unit(s), the request may be made by the county. Please check the
appropriate box and complete the following accordingly.
G G
SINGLE ASSESSING UNIT APPLICATION:
SWIS_____________
CITY/TOWN NAME________________ COUNTY NAME______________________
DATE OF FINAL ASSESSMENT ROLL*_______________ NUMBER OF PARCELS**__________________
* The date of the final assessment roll that was filed in the year immediately preceding or the year immediately
following the completion of the data collection program.
** The total number of separately assessed parcels appearing on the final assessment roll on behalf of which this
application is made, excluding special franchise parcels (roll section 5) which are assessed by the State.
G G
COUNTY APPLICATION:
The County of _________________ is applying on behalf of the assessing units listed on the back. Additional
sheets should be attached as needed.
********************************************************************************************************************
I,
the chief fiscal officer or assessing unit officer of
, do hereby make application for review of a Completion of a Plan
(City, town or county)
for the Collection and the Maintenance of Real Property Valuation Data and the Maintenance of Real
Property
pursuant to subdivision 1(b) of section 1572 of the Real Property Tax Law.
I hereby affirm that all cities and towns for which review is requested are using the same system for
which documentation is supplied.
Signed:
Date:
Fiscal or Assessing Officer
RP-3611(4/96)
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