Form Tp-592.2 - Real Estate Transfer Tax Claim For Refund printable pdf download

Form Tp-592.2 - Real Estate Transfer Tax Claim For Refund

New York State Department of Taxation and Finance

For office use only

Real Estate Transfer Tax Claim for Refund

Name of claimant

Name of representative or person to contact

Telephone number

(

)

Social security number

Employer identification number

Firm name, if applicable

Address of claimant

Address of person to contact

City, village or post office

State

ZIP code

City, village or post office

State

ZIP code

Location of property conveyed

(list each lot separately; attach additional sheets if necessary)

Address

County

Address

County

Date of transfer

(mm/dd/yyyy)

1 Amount of tax paid by claimant/assignor ..................................... 1.

Refund assignment: If the refund

is to be paid to someone other than

2 Amount of tax due ........................................................................ 2.

the person primarily liable for the

tax, mark an X in this box and see

3 Refund requested

..................................

instructions on back ...........................

(subtract line 2 from line 1)

Explanation: Give a full explanation below, including all facts on which your claim is based. Attach additional pages if necessary, and submit a copy

of all documentation necessary to substantiate your claim. In addition, if the Form TP-584, Combined Real Estate Transfer Tax Return, Credit Line

Mortgage Certificate, and Certification of Exemption from the Payment of Estimated Personal Income Tax, was filed with a recording officer rather

than directly with the Tax Department, submit a copy of the receipt provided by the recording officer at the time of payment.

, the claimant named above, or partner, officer, or other authorized

Certification: I

representative of the claimant, certify that the information contained in this claim is true and correct to the best of my knowledge, that no prior claim

for a refund of the whole or any part of the amount on line 3 has been filed, and that no part has previously been refunded to the claimant or any

assignee, except as specified herein.

Signature

Title or relationship to claimant

Date

TP-592.2 (4/13)

Form Tp-592.2 - Real Estate Transfer Tax Claim For Refund

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