Form Rp-420-A-Org - Application For Real Property Tax Exemption For Nonprofit Organizations - Mandatory Class I-Organization Purpose

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RP-420-a-Org (9/08)
NYS DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR REAL PROPERTY TAX EXEMPTION FOR
NONPROFIT ORGANIZATIONS - MANDATORY CLASS
I-ORGANIZATION PURPOSE
(See general information and instructions on back of form)
1a. Name of Organization
d. Name of contact person
e. Day telephone no. of contact person
b. Mailing address
Evening telephone no.
c. Employer ID no.
f. E-mail address (optional)
2a. Purpose(s) of organization:
Religious
Educational
Charitable
Moral or mental improvement of men, women, or children
Hospital
b. If the organization has more than one purpose, state the primary purpose:
c. State briefly specific activities related to each purpose checked above:
(Attach additional sheets if necessary)
FOR ASSESSOR’S USE
Assessing unit
County
City/Town
Village
School District

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