RP-459-a (9/08)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR PARTIAL EXEMPTION FOR REAL PROPERTY ALTERED,
INSTALLED OR IMPROVED TO REMOVE ARCHITECTURAL BARRIERS IN
COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT OF 1990
(General information and instructions for completing this form are on back.)
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
Village (if any)
___________________________________________
________________________________________
School District
City/Town
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot:
_______________________________________________________
4. General description of property (if necessary, attach plans or specifications):
_____________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
5. Use (s) of property:
_______________________________________________________________________
6. Describe alteration, installation or improvement made to property to remove architectural barriers on
behalf of disabled persons: ___________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
7. Cost of alteration, installation or improvement:
8a. Date construction of alteration, installation or improvement was commenced: ___________________
b. Date completed (attach certificate of occupancy or other documentation of completion):
I certify that all statements made above are true and correct.
_________________________________________
Signature
Date
Clear Form