Form Rp-7012-W - Application For Exemption From Filing Water Company Annual Financial Report

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RP-7012-W
New York State Department of Taxation and Finance
Office of Real Property Tax Services
(3/12)
Valuation Services Bureau
W A Harriman Campus
Albany NY 12227
Application for Exemption from Filing
Water Company Annual Financial Report
I hereby declare to the best of my knowledge and belief that
____________________________________ had for the fiscal year ending __________,
Name of Water Company
gross operating revenues totaling less than $250,000.
Application is hereby made for exemption from filing a Water Company Financial Report with
the Office of Real Property Tax Services.
____________________________
Signature
____________________________
Company name
Clear Form

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