Form Rp-523-Dcl - Notice Of Disclosure Of Interest Of Board Of Assessment Review Member In Parcel For Which Assessment Complaint Has Been Filed

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RP-523-Dcl (8/06)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
NOTICE OF DISCLOSURE OF INTEREST OF BOARD OF ASSESSMENT REVIEW MEMBER IN
PARCEL FOR WHICH ASSESSMENT COMPLAINT HAS BEEN FILED
I,
, a member of the Board of Assessment Review of the
name (print or type)
_____________________________________________ hereby disclose the following direct or
name of assessing unit (print or type)
indirect interest in real property for which an assessment complaint has been received by the Board:
1.
The parcel(s) in which I have a direct or indirect interest and for which a complaint has been
received is (are) described on the assessment roll as follows:
2.
The person having the interest in the parcel is
myself
my spouse
my minor child.
3.
The person having the interest
a.
is the owner of the parcel(s).
b.
is an (officer/director/partner/employee) of an entity which is the (owner/lessee)
of the parcel(s).
c.
is an (officer/director/partner/associate) of a (law firm/real estate firm) having a
financial interest with the (owner/lessee) of the parcel(s).
d.
legally or beneficially own(s) or control(s) stock of the corporate (owner/lessee)
of the parcel(s), which stock is listed on a major stock exchange or sold on the
over the counter market, and which stock has a current value of at least $10,000.
Signature of Member of Board of Assessment Review
Date filed
Signature of Chief Executive Officer of Assessing Unit
Date filed
GENERAL INFORMATION
Pursuant to section 523(3) of the Real Property Tax Law, a member of a board of assessment
review must disclose direct or indirect interests in real property for which assessment complaints have
been received by the board. This notice of disclosure of interest must be filed by the board member with
the chief executive officer of the assessing unit on or before the date the board submits to the assessor(s)
its verified list of changes to be made to the tentative assessment roll. Knowingly and intentionally
failing to disclose such an interest can result in the imposition of a $1,000 fine for each omission.
Note: This form need only be filed when the boar d of assessment r eview member , member 's
spouse, or member 's minor child has an inter est in pr oper ty for which a complaint has been filed,
and the inter est is one of those descr ibed in item 3 on the form.
Clear Form

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