Form Rp-523-Dcl - Notice Of Disclosure Of Interest Of Board Of Assessment Review Member In Parcel For Which Assessment Complaint Has Been Filed Page 2

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RP-523-Dcl (8/06)
2
INSTRUCTIONS (number s r efer to question number )
1.
Identify the parcel for which a complaint had been received and in which you have an
interest by entering its description as it appears on the assessment roll. Where the same
interest is present with respect to several parcels, you may combine them on the same
form, attaching additional sheets if necessary.
2.
Check the applicable line indicating whether it is (a) you, (b) your spouse, or (c) your
minor child (i.e., one under 18 years of age) who has the interest in the subject property.
3.
Check the applicable line indicating the interest in the subject property. Where necessary,
further describe the interest by striking out inapplicable choices that appear within
parentheses. For example, if you are an officer of an entity which owns a parcel for which
a complaint has been filed, you would check line b and strike out "director", partner" and
"employee" within the first set of parentheses and "lessee" within the second set.

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