RP-467-aff/s (8/11)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
AFFIDAVIT OF CONTINUED ELIGIBILITY FOR
PARTIAL SCHOOL TAX EXEMPTION
FOR REAL PROPERTY OF SENIOR CITIZENS AND FOR
ENHANCED SCHOOL TAX RELIEF (STAR) EXEMPTION
(See reverse side for general information and instructions)
State of New York
ss:
County of ________________________
______________________________________________, being duly sworn, depose(s) and say(s):
Name of owner (s)
1.
I am/We are the owner(s) of real property located at:
Street Address __________________________________________________________________
Village of _________________________, City/Town of ________________________________
State of New York
2.
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot ________________________________________________
3.
My/Our post office address is: ______________________________________________________
Telephone no. Day __________________________
Evening__________________________
4.
Since I/we last filed an application or affidavit for this exemption:
a.
there has been no change in the ownership of the property;
b.
there has been no change in marital status of the owners and all the owners continue to reside
on the property; and
c.
the property continues to be used exclusively for residential purposes.
5.
The i ncome o f t he o wner(s) f or p receding cal endar year d oes n ot ex ceed the m aximum income
eligibility level established by the school district.
6.
There a re no c hildren of ow ners, t enants or l essees r esiding i n t he pr operty w ho a ttend publ ic
school, grades Kindergarten through twelve, or if there are such children residing in the property,
the school district in which the property is located has opted to permit a school tax exemption in
such situations. If there are such children residing in the property, they were not brought into the
property in whole or in substantial part for the purpose of attending a particular school within the
school district.
_______________________________________
Signature of owner
_______________________________________
Signature of owner
Subscribed to and sworn to before me, this
________________day of ___________________20_____
________________________________________________
Commissioner of deeds or notary public
Clear Form