Form Rp-458-A - Application For Alternative Veterans Exemption From Real Property Taxation

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RP-458-a (1/03 (rev. 8/06))
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR ALTERNATIVE VETERANS EXEMPTION
FROM REAL PROPERTY TAXATION
(General information and instructions for completing this form are contained in Form RP-458-a-Ins)
l.
Name and telephone no. of owner(s)
2. Mailing address of owner(s)
Day No. (
)
Evening No. (
)
E-mail address (optional)
3. Location of property (see instructions)
___________________________________________
_____________________________________
Street address
Village (if any)
__________________________________________
City/Town
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
4. Is the owner a veteran who served in the active military, naval or air service of the United States?
Yes
No
If No, indicate the relationship of the owner to veteran who rendered such service: ______________________
If Yes, is the veteran also the unremarried surviving spouse of a veteran?
Yes
No
5. Indicate branch of veterans service and dates of active service:
(Attach written evidence)
6. Was the veteran discharged or released from the active service under honorable conditions?
Yes
No
(Attach written evidence)
7. Did the veteran serve in a combat zone or combat theater?
Yes
No
If Yes, where did the veteran serve and when was such service performed?_____________________________
(Attach written evidence)
8. Has the veteran received, or did the veteran receive prior to his/her death, a compensation rating from the
United States Veteran’s Administration or from the United States Department of Defense as a result of a
service connected disability?
Yes
No
If Yes, what is (was) the veteran’s compensation rating?
(Attach written evidence showing the date such rate was established)
check if rating is permanent?
If No, did the veteran die in service of a service connected disability or in the line of duty while serving during
wartime?
Yes
No (Attach written evidence)
9. Is the property the primary residence of the veteran, unremarried surviving spouse of the veteran or Gold Star
parent?
Yes
No
If No, is the veteran, unremarried surviving spouse of the veteran or Gold Star parent the owner of the property
and absent from the property due to medical reasons or institutionalization?
Yes
No
Explain:
10. Is the property used exclusively for residential purposes?
Yes
No
If No, describe the non-residential use of this property and state what portion is so used. __________________

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