Form Mt-15.1 - Mortgage Recording Tax - Claim For Refund
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New York State Department of Taxation and Finance
Mortgage Recording Tax
Claim for Refund
Name of claimant
Name of person to contact
Telephone number
(
)
Social security number
Employer identification number
Name of claimant’s representative
Address of claimant’s representative
(number and street or rural route)
(number and street or rural route)
Address of claimant
City, village or post office
State
ZIP code
City, village or post office
State
ZIP code
Name of mortgagor
Name of mortgagee
Principal indebtedness secured by mortgage
Date tax was paid
County where tax was paid
If the claimed refund is to be paid to someone other than the mortgagor or the mortgagee, you must attach an
acknowledged assignment or an affidavit and check this box ...................................................................................
1 Amount of tax paid by claimant ............ 1
2 Amount of tax due ................................ 2
Give a full explanation below, including all facts on
3 Refund requested
which your claim is based, and submit a copy of the
(subtract line 2 from line 1)
................... 3
recorded mortgage and all other documents necessary
to substantiate your claim.
(continued)
All refund applications must be signed and notarized on the back of this form.
MT-15.1 (10/14)
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