Form Rp-421-H - Application For Real Property Tax Exemption For Capital Improvements To Multiple Dwelling Buildings Within Certain Cities

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NYS DEPARTMENT OF TAXATION & FINANCE
RP-421-h (1/04 rev.)
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR REAL PROPERTY TAX EXEMPTION FOR CAPITAL
IMPROVEMENTS TO MULTIPLE DWELLING BUILDINGS WITHIN CERTAIN CITIES
(Real Property Tax Law, Section 421-h)
(Instructions for completing this form are contained in Form RP-421-h-Ins (1/04(rev.)) [Lockport/Peekskill]
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 (see instructions)
Street Address
City of Lockport
City of Peekskill
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
4. a. Date title to multiple dwelling was acquired by owner ____________
b. Date owner occupied property
____________
c. Property for which exemption is sought has been converted from a multiple dwelling back to an
owner-occupied
___one-family/___two-family residence. (check one)
5.
a. Square footage of residence without improvement
________
square feet
b.
Square footage of residence with improvement
_________
square feet
c. As measured by square footage in question 5b, is more than one-half of the residence
at least five years old?
___yes
___no
6. a. Date of commencement of construction of improvement converting multiple dwelling to one-or
two-family residence
____________
b. Date completed (attach copy of certification of occupancy or other documentation of
completion) ________________
7. Describe the improvement for which exemption is sought (attach additional sheets if
necessary).
_________________________________________________________
_______________
8. Cost of improvement: $______________ (supply documentation)

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