Form Rp-412-A - Application For Real Property Tax Exemption

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NYS DEPARTMENT OF TAXATION & FINANCE
RP-412-a (1/95)
OFFICE OF REAL PROPERTY TAX SERVICES
INDUSTRIAL DEVELOPMENT AGENCIES
APPLICATION FOR REAL PROPERTY TAX EXEMPTION
(Real Property Tax Law, Section 412-a and General Municipal Law, Section 874)
1. INDUSTRIAL DEVELOPMENT AGENCY (IDA)
2. OCCUPANT (IF OTHER THAN IDA)
(If more than one occupant attach separate listing)
Name _______________________________________
Name ____________________________________
Street _______________________________________
Street ____________________________________
City ________________________________________
City _____________________________________
Telephone no. Day (
)______________________
Telephone no. Day (
) __________________
Evening (
)___________________
Evening (
) _______________
Contact _____________________________________
Contact ___________________________________
Title ________________________________________
Title _____________________________________
3. DESCRIPTION OF PARCEL
a. Assessment roll description (tax map no.,/roll year)
d. School District_________________________
_________________________________________
b. Street address _____________________________
e. County _______________________________
_________________________________________
f. Current assessment ______________________
c. City, Town or Village _______________________
g. Deed to IDA (date recorded; liber and page)
_____________________________________
4. GENERAL DESCRIPTION OF PROPERTY
(if necessary, attach plans or specifications)
a. Brief description (include property use) ___________________________________________________
____________________________________________________________________________________
b. Type of construction __________________________________________________________________
c. Square footage _________________
f. Projected expiration of exemption (i.e.
date when property is no longer
d. Total cost _____________________
possessed, controlled, supervised or
under the jurisdiction of IDA)
e. Date construction commenced ____________________
_____________________________________
5. SUMMARIZE AGREEMENT (IF ANY) AND METHOD TO BE USED FOR PAYMENTS TO BE
MADE TO MUNICIPALITY REGARDLESS OF STATUTORY EXEMPTION
(Attach copy of the agreement or extract of the terms relating to the project).
a. Formula for payment __________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
b. Projected expiration date of agreement _______________________________________________________

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