Form Tp-584-Sny - Real Estate Transfer Tax Return For Start-Up Ny Leases
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2TP-584-SNY (1/14)
Recording office time stamp
New York State Department of Taxation and Finance
Real Estate Transfer Tax Return
for START-UP NY Leases
See instructions on back before completing this form. Print or type.
Information relating to conveyance
(if individual, last, first, middle initial) (
mark an X if more than one grantor)
Grantor/Transferor
Name
Social security number
Individual
Mailing address
Social security number
Corporation
Partnership
City
State
ZIP code
Federal EIN
Estate/Trust
Single member LLC
(see instructions)
Single member EIN or SSN
Single member’s name if grantor is a single member LLC
Other
(if individual, last, first, middle initial) (
mark an X if more than one grantee)
Grantee/Transferee
Name
Social security number
Individual
Mailing address
Social security number
Corporation
Partnership
City
State
ZIP code
Federal EIN
Estate/Trust
Single member LLC
(see instructions)
Single member EIN or SSN
Single member’s name if grantee is a single member LLC
Other
Location and description of property conveyed
Tax map designation –
Street address
City, town, or village
County
Section, block & lot
(include dots and dashes)
(mark an X in the appropriate box)
Condition of conveyance
(see instructions)
Leasehold grant - enter maximum term of lease, including all option periods
:
Leasehold assignment
Date of conveyance
month
day
year
The undersigned certify that the conveyance of real property is exempt from the real estate transfer tax because the conveyance is a lease
of real property located in a tax-free NY area to an approved business participating in the START-UP NY program. The undersigned further
certify that the information contained in this form, including any certifications or attachments, is to the best of his/her knowledge, true and
complete, and authorize the person(s) submitting such form on their behalf to receive a copy for purposes of recording the lease or other
instrument effecting the conveyance.
Grantor signature
Title
Grantee signature
Title
Grantor signature
Title
Grantee signature
Title
For recording officer’s use
Date received
Transaction number
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