RP-460 (9/08)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR PARTIAL TAX EXEMPTION FOR
REAL PROPERTY OF MEMBERS OF THE CLERGY
(See information and filing requirements on back of form)
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
Street address
Village (if any)
City/Town
School District
Parcel identification no. (see tax bill or assessment roll)
Tax map number or section/block/lot __________________________________________________________
Attach document providing ownership, such as deed, if not previously submitted
4. Is applicant an actual resident and inhabitant of the State of New York?
Yes
No
5. Is applicant engaged in ministerial work assigned to him/her by the church or denomination of which
applicant is a member, such work constituting applicant’s principal occupation?
Yes
No
If yes, indicate name of church or denomination: ________________________________________________
If no, indicate alternative basis for exemption:
Applicant is unable to perform his/her religious duties due to impaired health. (attach documentation
such as physician’s statement)
Applicant i s ov er seventy y ears o f ag e. ( Attach documentation such as birth o r baptismal c ertificate
if not previously submitted)
Applicant i s s urviving spo use of a m ember of t he clergy w ho met t he requirements of this statute at
the time of his/her death, and applicant has not remarried.
Name of deceased spouse ______________________________________________________________
Name of deceased spouse’s church or denomination _________________________________________
6. Is the applicant occupied in secular employment?
Yes
No
If yes, indicate amount of time devoted to: a. secular employment: _______________ per ____________
b. religious duties:
_______________ per ____________
Description of secular duties: _______________________________________________________________
_______________________________________________________________________________________
7. Is applicant the owner of other real property in the State of New York which is exempt from taxation pursuant
to this statute?
Yes
No
a. If yes indicate location of property:
__________________________
___________________
________________________________
(City, Town, Village)
(County)
(School District)
b. Amount of exemption on other property $____________________
I, __________________________________________hereby certify that the information on t his application, and
any accompanying papers constitute a true statement of fact.
(Signature of owner or authorized representative)
Date
Clear Form