Owner'S Registration Card - New York City Department Of Finance Page 2
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2Owner’s Registration Card
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B I L L I N G I N F O R M AT I O N - S P E C I A L A S S E S S M E N T B I L L S
INDICATE TO WHOM SPECIAL ASSESSMENT BILLS SHOULD BE MAILED. (SEE INSTRUCTIONS FOR LINE
10.
T Y P E O F S P E C I A L A S S E S S M E N T B I L L :
Name of Recipient
Address
City
State
Zip Code
Relationship of addressee to property
(Check
one)
Owner
Tenant
Agent
If "TENANT" is checked provide either Social Security Number or Employer Identification Number,
whichever is applicable.
SSN
EIN
T Y P E O F S P E C I A L A S S E S S M E N T B I L L :
Name of Recipient
Address
City
State
Zip Code
Relationship of addressee to property
(Check
one)
Owner
Tenant
Agent
If "TENANT" is checked provide either Social Security Number or Employer Identification Number,
whichever is applicable.
SSN
EIN
NOTE: Water and Sewer Charge registration requires a different form.
Contact the Bureau of Water and Energy Conservation at (718) 595-7000.
Signature of owner or corporate officer
Date
11.
12.
(required by statute)
____ / ____ / ____
If you need assistance in completing this form, please call Taxpayer
Assistance at (718) 935-9500. Si usted necesita recibir asistencia en
Español para llenar esto formulario, llame al (718) 935-9500 y solicite un
Representante que hable Español.
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