Form Rp-420-A/b-Rnw-Ii - Renewal Application For Real Property Tax Exemption For Nonprofit Organizations Ii - Property Use
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2RP-420-a/b-Rnw-II (9/08)
NYS DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
RENEWAL APPLICATION FOR REAL PROPERTY TAX EXEMPTION
FOR NONPROFIT ORGANIZATIONS
II – PROPERTY USE
(See general information and instructions on back form)
1a. Name of organization
d. Name of contact person
b. Mailing address
e. Telephone no. of contact person
Day (
)
Evening (
)
f. E-mail address (optional)
c. Employer ID no.
g. Property identification (see tax bill or assessment roll) Tax map number or section/block/lot
2. Have any of the following changes occurred since application for this property tax exemption was last filed?
If any of the listed changes have occurred, please give a detailed explanation of each change on the back of
this form, check the appropriate line below, and complete and sign the statement. If none of the changes has
occurred, please check the appropriate line below and complete and sign the statement.
a. A change has occurred in the ownership of all or part of the property.
b. A change has occurred in the use or uses of the property by the owner.
c. A change has occurred in that all or part of the property is now being offered for sale or lease.
d. All or part of the property is occupied by an organization other than the owner: the user
organization(s) make payments for use of the property, and a change has occurred in (1) the
proportion of the property so occupied, (2) the terms of the occupancy, or (3) the payments made by
the occupant(s).
e. Physical changes in the property (such as construction, alterations, or demolition) have occurred.
f. A change has occurred in the nature or schedule of planned construction of buildings or other
improvements on an unimproved portion of the property.
g. One of the organization’s purposes is hospital, and a change has occurred in the amount of
space or time that the property is used for the private practice of staff members or others
rather than for the direct hospital related activities.
STATEMENT OF CHANGE
I hereby certify that all of the changes, as listed above, that have occurred since application for
exemption was last filed have been noted and the explanations of such charges are true and correct to the
best of my knowledge and belief.
STATEMENT OF NO CHANGE
I hereby certify that none of the changes listed above has occurred since application for exemption was
last filed to the best of my knowledge and belief.
Signature
Date
Title
FOR ASSESSOR’S USE
Assessing unit
County
City/Town
Village
School District
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