Form Exc-0106 - Application To Remove Previously Granted Exemption(S)
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2NYC DEPARTMENT OF FINANCE - PROPERTY DIVISION
APPLICATION TO REMOVE PREVIOUSLY
TM
GRANTED EXEMPTION(S)
Department of Finance
Mail to: NYC Dept. of Finance, Homeowner Tax Benefits/Compliance Unit, 66 John Street, 3
Floor, New York, New York 10038.
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INSTRUCTIONS: Fill out this application to remove a property tax exemption you currently receive. DO NOT use this
application to apply for an exemption. To apply for an exemption, please submit the Homeowner Tax Benefit Application
available on our website:
NOTE: If you are requesting your homeowner exemption be removed for a prior tax year or multiple prior tax years you
will be charged a $500 processing fee in addition to the adjusted property tax and any interest due.
PROPERTY INFORMATION (please remember to include any unit number)
Mailing Address:
Unit/Apartment Number:
Borough:
Block:
Lot:
City:
State:
Zip Code:
SECTION 1 - NYS STAR Property Tax Credit
I am requesting to rescind (remove) my STAR/ESTAR exemption with the New York City Department of Finance so
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that I can apply directly with the New York State Dept. of Taxation and Finance for the STAR credit.
SECTION 2 - Removal of Property Tax Exemption(s)
Please select from the list below (check all that apply):
STAR - Basic or Enhanced
Veterans
Senior Citizen/Disabled
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Homeowners Exemption
Crime Victim/Good Samaritan
Condo/Cooperative Abatement
Clergy
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A) On _______-________-_______ the homeowner passed away. A copy of the death certificate is attached.
MONTH
DAY
YEAR
nnnnnnnnn
Decedent’s name: ______________________________________ Decedent’s SS#
B) As of_______-________-_______ I am voluntarily renouncing the exemption(s) as described above.
MONTH
DAY
YEAR
SECTION 3 - Signatures and Certifications
All owners must sign, date and provide their Social Security numbers. By signing below, I certify that all statements
made on this application are true and that I have made no willful false statements of material fact.
______________________
______________________
_______________
’
PRINT NAME
OWNER
S SIGNATURE
SOCIAL SECURITY NUMBER
DATE
______________________
______________________
_______________
’
PRINT NAME
OWNER
S SIGNATURE
SOCIAL SECURITY NUMBER
DATE
______________________
______________________
_______________
’
PRINT NAME
OWNER
S SIGNATURE
SOCIAL SECURITY NUMBER
DATE
EXC-0106 01.09.2017
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