RP-6110
New York State Department of Taxation and Finance
Office of Real Property Tax Services
(5/13)
Notice of Anticipated Material Change in Level of
Assessment and Request for Special Equalization Rate
County of
Year of assessment roll
Town of
Municipal SWIS code
Village
Instructions: also see the more detailed instructions, Form RP-6110-I
Pursuant to rules (20 NYCRR subpart 8186-3), if there is an anticipated change in level of assessment of
2% or more from the prior roll to the current roll, the assessor must submit this notice to the State Office
of Real Property Tax Services no later than 30 days before the filing of the final assessment roll. We will,
in turn, notify the appropriate school district(s) and county officials as well as personnel within this office
that are responsible for establishing taxable state land, special franchise and railroad ceiling property
assessments and ceilings of the possibility of the establishment of a special equalization rate.
A worksheet for computing the estimated change in level of assessment is provided on the back of this
form. If the estimated change in level of assessment in column H on the back of this form is equal to or
greater than plus or minus .0200 (2%), submit this notice to:
NYS TAX DEPARTMENT
EQUALIZATION SUPPORT SERVICES
W A HARRIMAN CAMPUS
ALBANY NY 12227
Is a revaluation or update being completed on this roll?
Yes
No
If Yes, the uniform percentage applied to all assessments is _____________%
The valuation date or revaluation or update is _______________________
____________________________________________________________________________
I certify that the anticipated change in level of assessment for the assessment roll indicated
above is equal to or greater than plus or minus .0200 (2%).
Assessor’s name (print or type)
Assessor’s signature
Date