Form Rp-459-C - Application For Partial Tax Exemption For Real Property Of Persons With Disabilities And Limited Incomes
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2RP-459-c (9/09)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR PARTIAL TAX EXEMPTION FOR REAL PROPERTY OF
PERSONS WITH DISABILITIES AND LIMITED INCOMES
APPLICATION MUST BE FILED WITH YOUR LOCAL ASSESSOR BY TAXABLE STATUS DATE
Do not file this form with the Office of Real Property Tax Services.
General information and instructions for completing this form are contained in RP-459-c-Ins
l.
Name and telephone no. of owner(s)
2. Mailing address of owner(s)
Day No. (
)
Evening No. (
)
E-mail address (optional) ___________________________________________________________________
3. Location of property (see instructions):
Street address
City/Town
Village (if any)
School District
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
4. Description of nature of applicant’s physical or mental impairment which currently substantially limits one or
more major life activities (e.g. walking)
5. Indicate documents submitted with application as proof of disability (See instruction #5)
Award letter from Social Security Administration of entitlement to social security disability insurance
(SSDI) or supplemental security income (SSI)
Award letter from Railroad Retirement Board of entitlement to railroad retirement disability benefits
Certificate from State Commission for the Blind and Visually Handicapped stating that applicant is legally
blind
Award letter from United States Postal Service certifying disability pension
Award letter from United States Department of Veterans Affairs certifying disability pension
6. Indicate document submitted with application as proof of ownership (See instruction #6):
Deed
Mortgage
Other (specify)
7. Do all the owners of the property presently occupy the premises as their legal residence?
Yes
No
If answer to question 7 is No, is an owner receiving medical care as an in-patient in a residential health care
facility?
Yes
No If answer is Yes, specify name and location of the facility.
8. Is any portion of the property used for other than residential purposes (farming, commercial, vacant land,
professional office, etc.)?
Yes
No
If answer is Yes, explain such use and describe the portion
that is so used. __________________________________________________________________________
_______________________________________________________________________________________
9. Income of each owner and spouse of each owner for the calendar year immediately preceding date of
application MUST be set forth on next page (attach additional sheets if necessary). See instruction #9 for
income to be included. (NOTE: Income does NOT include gifts, inheritances or a return of capital.)
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