Form Rp-491 - Application For Conservation Easement Agreement Exemption - Certain Towns
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2RP-491 [Elma] (9/09)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR CONSERVATION EASEMENT AGREEMENT EXEMPTION;
CERTAIN TOWNS
Application for exemption must be filed with Town of Elma Assessor by March 1
Do not file form with the Office of Real Property Tax Services
l.
Name and telephone no. of owner(s)
2. Mailing address of owner(s)
Day No. (
)
Evening No. (
)
E-mail address (optional)
3. Location of property
a.
, Town of Elma
Street address
Property identification (see tax bill or assessment roll)
b. Tax map number or section/block/lot
4. Conservation easement encumbers:
the entire parcel identified in 3.b. or
a portion of the parcel identified in 3.b (attach survey or other documentation identifying portion
subject to easement)
Attach copy of conservation easement agreement as adopted by town board.
5. The property to which the conservation easement applies is subject to a commitment for the preservation of
open space or open area for a period of:
15 to 29 years
30 to 49 years
50 to 75 years
perpetuity
Certification
I, ____________________________________, certify that the information on this application and any
accompanying pages constitutes a true statement of facts.
Signature
Date
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