Form Rp-421-M - Application For Real Property Tax Exemption For Certain New Or Substantially Rehabilitated Multiple Dwellings

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New York State Department of Taxation and Finance
RP-421-m (2/12)
Office of Real Property Tax Services
Application for Real Property Tax
Exemption for Certain New or
Substantially Rehabilitated Multiple Dwellings
(Real Property Tax Law, section 421-m)
(Instructions for completing this form are contained in Form RP-421-m-Ins)
1. Name of owner(s)
2. Name of contact person
Mailing address
Daytime phone number
Evening phone number
E-mail address (optional)
3. Location of property (see instructions)
Street address
Village (if any)
City/Town
School district
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
Is property located in a designated benefit area as set forth in municipal law? Yes
No
4. Description of property for which exemption is sought
a) Prior land use - Indicate the land use of the parcel when the improvement was started:
Vacant
Predominantly vacant
Under-utilized land
Contained a non-conforming use
Contained a substandard, structurally unsound or unsanitary dwelling
If other than Vacant, provide details: ____________________________________________________
b) Nature of improvement
New construction
Substantial rehabilitation (see instructions for definition)
Provide details: _____________________________________________________________________
5. Date when construction or substantial rehabilitation of structure commenced: ___________________
6. Was construction or substantial rehabilitation carried out with grants of financial assistance from a federal,
state or local agency? Yes
No
If Yes, attach documentation.

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