Form Rp-483-B - Application For Tax Exemption For Reconstructed Or Rehabilitated Historic Barn Page 2

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RP-483-b (1/97)
2
CERTIFICATION
I, ______________________________________
thereby certify that the information on this application and
any accompanying pages constitutes a true statement of facts.
____________________________________________
______________________________________
Signature
Date
Clear Form
__________________________________________________________________________________________
FOR ASSESSOR'S USE
1. Date application filed: ____________________________________________________________________
2. Applicable taxable status date: ______________________________________________________________
3. Action on application:
Approved
Disapproved
4. Assessed valuation of parcel in first year of exemption: $ __________________________
5. Increase in total assessed valuation in first year of exemption: $ _____________________
6. Amount of exemption in first year:
Percent
Amount
County
_________________
$ ________________________
City/Town
_________________
$ ________________________
Village
_________________
$ ________________________
School District
_________________
$ ________________________
____________________________________________
______________________________________
Assessor’s Signature
Date

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