Form Rp-420-A/b-Org - Application For Real Property Tax Exemption For Nonprofit Organizations

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SCHEDULE A
NYS DEPARTMENT OF TAXATION & FINANCE
RP-420-a/b-Org (1/95)
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR REAL PROPERTY TAX EXEMPTION FOR
NONPROFIT ORGANIZATIONS
ALL organizations filing this form must complete Parts A, B and C. FOUNDATIONS and TRUSTS
must complete Part D. Certain organizations must complete additional parts of this form as follows.
RELIGIOUS ORGANIZATIONS…….Part E
CHARITABLE ORGANIZATIONS THAT ARE NOT FOUNDATIONS OR TRUSTS……Part F
HOSPITAL ORGANIZATIONS…….Part G
EDUCATIONAL ORGANIZATIONS…….Part H
ORGANIZATIONS THAT OPERATE HOMES FOR THE AGED…….Part I
Attach additional sheets if necessary. On each attachment, indicate name of organization, employer
identification number and question answered. If assistance is needed in completing this form, consult the
assessor.
ALL ORGANIZATIONS MUST COMPLETE THE VERIFICATION ON PAGE 19
PART A-IDENTIFICATION
_____________________________________
_____________________________________
.
1a. Name of Organization
c. Employer ID no
_____________________________________
_____________________________________
d.
Name of contact person
_____________________________________
_____________________________________
b.
Mailing address
e. Day telephone no. of contact person
_____________________________________
f. Evening telephone no.
2. Date incorporated or formed ______________
3. Month annual accounting period ends ____________
4. Has the organization filed Federal Income Tax Returns? ____Yes ____No
If YES, state form number(s), year(s) filed, and Internal Revenue Office where filed.
Part B—ACTIVITIES AND OPERATIONS
1. Describe in detail the specific purposes for which the organization was formed, the activities presently carried
on and those which will be carried on. If the organization is not fully operational, explain what stage of
development its activities have reached, what further steps remain for the organization to become fully
operational, and when they will take place. Specifically identify the services performed or to be performed by
the organization. (Do not state the purposes of the organization in general terms or repeat the language of the
organizational documents). Include sufficient information to show that the organization’s activities are related
to the purpose(s) stated in Question 2a Form RP-420-a-Org or RP-420-b-Org.

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