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Disabled Homeowners' Exemption (Dhe) Renewal Application For 2017/18 - New York Department Of Finance Page 3

Disabled Homeowners’ Exemption (DHE)

RENEWAL APPLICATION FOR 2017/18

Please be sure that ALL HOMEOWNERS sign the Certiﬁcation section of this application on page 4.

Mail completed application by January 16, 2018 to:

New York City Department of Finance, P.O. Box 311, Maplewood, N.J. 07040-0311

PLEASE PRINT

1. PROPERTY INFORMATION

BOROUGH

BLOCK

LOT

# OF COOPERATIVE SHARES

STREET ADDRESS

APT.

CITY

STATE

ZIP

TYPE OF PROPERTY

Condominium unit

1–3 family dwelling

IF FAMILY UNIT WITH 4 OR MORE UNITS, ENTER

Cooperative

4+ family dwelling

% OF SPACE USED FOR PRIMARY RESIDENCE: ____________ %

DATE YOU PURCHASED THE

COOPERATIVE/CONDO MANAGEMENT INFORMATION

PROPERTY (mm/dd/yyyy)

COMPANY NAME

TELEPHONE

(

)

–

NUMBER

Yes

IS THERE A LIFE ESTATE ON THIS PROPERTY?

Yes

IS THERE A TRUST ON THIS PROPERTY?

Yes

WAS THE PROPERTY WILLED TO YOU?

FOR COOPERATIVES ONLY: IS YOUR UNIT RECEIVING SENIOR CITIZEN RENT INCREASE EXEMPTION (SCRIE) OR

Yes

DISABILITY RENT INCREASE EXEMPTION (DRIE)?

IS THE PROPERTY THE PRIMARY RESIDENCE FOR ALL DISABLED OWNERS AND THEIR SPOUSES? (ALL OWNERS

Yes

MUST RESIDE ON THE PROPERTY UNLESS THEY ARE LEGALLY SEPARATED, DIVORCED, ABANDONED OR

RECEIVING MEDICAL CARE IN A HEALTH CARE FACILITY)

Yes

IF THE DISABLED OWNER IS RECEIVING MEDICAL CARE IN A HEALTH CARE FACILITY, DO YOU RESIDE ON THE

PROPERTY ALONE?

2. OWNER(S) INFORMATION

• For a life estate, provide owner info for life estate holder and spouse.

• For a trust, provide owner info for beneficiary/trustee and submit copy of entire Trust Agreement.

• If an owner is deceased, do not include info. Submit copy of death certificate.

• If the property was willed to an owner, please submit copy of last will and testament, probate or court order.

• For divorced, legally separated, or abandoned owners, do not include info for absent owner. Submit copy of

court documents.

• For owner receiving medical care in a health care facility, submit documentation from health care facility.

8/22/2017

Disabled Homeowners' Exemption (Dhe) Renewal Application For 2017/18 - New York Department Of Finance Page 3

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