Form Rp-444-A - Application For Partial Exemption For Alteration Or Rehabilitation Of Historic Real Property

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RP-444-a (9/08)
NYS DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR PARTIAL EXEMPTION FOR ALTERATION OR
REHABILITATION OF HISTORIC REAL PROPERTY
(General information and instructions for completing this form are on back.)
1. Name and telephone no. of owner (s)
2. Mailing address of owner(s)
_______________________________________
________________________________________
_______________________________________
________________________________________
Day no. (
) __________________________
________________________________________
Evening no. (
) _______________________
________________________________________
E-mail (optional) _________________________________________________________________________
3. Location of property
Street address ____________________________________________________________________________
Village (if any) ________________________________
City/Town _______________________________
School district
__________________________________________________________________________
Parcel identification no. (see tax bill or assessment roll)
Tax map number or section/block/lot _________________________________________________________
4. General description of property: _____________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
5. Use(s) of property: ________________________________________________________________________
6a. Date construction of alteration or rehabilitation was commenced: ___________________________________
b. Date completed (attach certificate of occupancy or other documentation of completion): _________________
7. Cost of alteration or rehabilitation: _______________________________
8. Describe how alteration or rehabilitation made to property accomplishes the purposes of historic preservation:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
9. Attach proof of landmark or historic district designation. For property in a historic district, explain how
property contributes to the district’s historic character: ___________________________________________
_______________________________________________________________________________________
10. Attach approval of local preservation commission for alteration or rehabilitation.
I certify that all statements made above are true and correct.
_____________________________________
_______________________
Signature of Owner
Date
Clear Form

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