Form Rp-6371-Bar - Lake Ontario And Connected Waterways Assessment Relief Act Complaint On Real Property Assessment

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RP-6371-BAR
Department of Taxation and Finance
Office of Real Property Tax Services
Lake Ontario and Connected
(7/17)
Waterways Assessment Relief Act
Complaint on Real Property Assessment
Part 1 – General information
(city, town, village, or county)
Before the Board of Assessment Review for .........................................................
Name(s) of owner(s)
Mailing address of owner(s)
Location of property
(number and street or PO Box)
(street address)
City, village, or post office
State
ZIP code
City, town, or village
State
ZIP code
Daytime contact number
Evening contact number
School district
Email address
Tax map number of section/block/lot: Property identification
(see tax bill or assessment roll)
Part 2 – Information necessary to determine loss of improved value of property
Percent of assessment reduction granted on the assessment roll ...........................................
Indicate property owner’s claimed loss to improvements on the property (excluding value of the land):
10-19%*
20-29%*
30-39%*
40-49%*
50-59%
60-69%
70-79%
80-89%
90-99%
100%
* Assessment relief for a loss of less than 50% of improved value is available only if the municipality’s local law or resolution has
specifically authorized relief in those loss categories.
Describe in detail the damage to the improvements on the property caused by the flooding that occurred between April 1,
2017 and July 1, 2017, and the condition of the property following the flooding. Attach any, and all, reports from an
insurance adjuster, and any other supporting documentation. If that material was included in the application you submitted
to the assessor, you may submit a copy of that application instead.
(continued)

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