Form Rp-467-Aff/s - Affidavit Of Continued Eligibility For Partial School Tax Exemption For Real Property Of Senior Citizens

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RP-467-aff/s
Department of Taxation and Finance
Office of Real Property Tax Services
Affidavit of Continued
(7/16)
Eligibility for Partial School Tax
Exemption for Real Property of
Senior Citizens
State of New York:
County:
, being duly sworn, depose(s) and say(s):
(Name of owner(s))
1 I am (We are) the owner(s) of real property located at:
Street address
Village of
,
City/Town of
State of New York
2 Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot:
3 Mailing address:
Telephone number
Day: (
)
Evening: (
)
4 Since I (we) last filed an application or affidavit for this exemption:
a. there has been no change in the ownership of the property;
b. there has been no change in marital status of the owners and all of the owners continue to reside on the
property; and
c. the property continues to be used exclusively for residential purposes.
5 The income of the owner(s) for preceding calendar year does not exceed the maximum income eligibility level
established by the school district.
6 There are no children of owners, tenants or lessees residing in the property who attend public school, grades pre-k
through twelve, or if there are such children residing in the property, the school district in which the property is located
has opted to permit a school tax exemption in such situations. If there are such children residing in the property, they
were not brought into the property in whole or in substantial part for the purpose of attending a particular school within
the school district.
Certification
Subscribed to and sworn to before me, this
day of
, 20
.
Signature of Owner
Commissioner of deeds or notary public
Signature of Owner

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