Form Rp-421-L - Application For Real Property Tax Exemption For Capital Improvements To Residential Buildings In Certain Towns

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RP-421-L
New York State Department of Taxation and Finance
Office of Real Property Tax Services
(12/12)
Application for Real Property Tax Exemption for
Capital Improvements to
Residential Buildings in Certain Towns
(Real Property Tax Law, Section 421-L, for use in Town of Evans, Erie County only)
(See instructions, Form RP-421-L-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
4. Is this property used exclusively for residential purposes?
Yes
No
If No, STOP! The property does not qualify for this exemption.
5. Description of property for which exemption is sought:
a. Reconstruction
Alteration
Improvement
b. Cost of project: ______________
(do not include costs pertaining to ordinary maintenance and repairs)
c. Date project was started: ________________________
d. Date completed
____________
(attach copy of Certificate of Occupancy)
Certification
I, ____________________________________, hereby certify that the information on this application and any
accompanying pages constitutes a true statement of facts.
_____________________________________________
______________________
Signature
Date

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