Veterans Property Tax Exemption Application Form
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1
2Veterans Property Tax Exemption Application
Page 3
Section 1 - ownership / personal information
1.
Borough: __________________________ Block: ______________ Lot: ____________
Address of property: _______________________________________________________________ Zip Code: _________________
2.
Is this property used exclusively for residential purposes? ...........................
yes
no
If "
", State the percentage of nonresidential space: ______________________________________
no
3.
Type of residence (check one):
1-, 2-, 3-family home
condominium unit
cooperative apartment - unit number: ___________
4.
Applicant is (check one) (attach proof of status):
VETERAN
SPOUSE OF VETERAN
UNREMARRIED SPOUSE OF DECEASED VETERAN
OTHER
_________________
(specify)
5.
Name of applicant: __________________________________________________________________________________________
Work telephone number: ____________________________
Home telephone number: _____________________________
Veteran’s Social Security Number ___ ___ ___ - ___ ___ - ___ ___ ___ ___ Branch of active service: _____________________
Date of beginning of service: ________________ Date of honorable discharge or release from service: ______________________
(You must attach documentation.) (See "Information Needed to Prove Eligibility" and "Checklist")
Spouse’s Social Security Number ___ ___ ___ - ___ ___ - ___ ___ ___ ___
6.
Is the address the legal and primary residence of the applicant(s)? ..........................................
yes
no
7.
Is any owner now in a nursing home or institution? ..................................................................
yes
no
If "
", state owner's name: _________________________________________________ Date entered: ______________________
yes
Section 2 - service-related information
1.
In which war or period of conflict did the veteran serve? (See "Service Requirements", page 1, for list) _______________________
___________________________________________________________________________________
2.
Did the veteran serve in a combat zone or combat theatre?
.............................................................
yes
no
If "
", where did the veteran serve and when was such service performed? (You must attach documentation.) (See "Information
yes
Needed to Prove Eligibility" and "Checklist") ________________________________________________________________________
3.
Has the veteran received or did the veteran receive, prior to his/her death, a compensation rating from the United States Veterans
Administration as a result of a service-connected disability?
...........................................................
yes
no
If "
", attach a letter of disability rating, dated within the last 12 months, from the US Department of Veterans Affairs, NY Regional
yes
Office, documenting the veteran's disability rating. (You may obtain this letter by calling toll free 1-800-827-1000.)
Section 3 - other information
1a. Is the owner(s) now receiving a Veterans Exemption anywhere in New York City or New York State? .............................
yes
no
b. If "
", complete the following: Street Address: ____________________________________________________________________
yes
County: ____________________________
Block: ________________
Lot: ______________
2a. Is the owner(s) now receiving benefits based on service as a Veteran anywhere other than
in New York City or New York State? .............................................................................................................................
yes
no
b. If "
", specify address: ______________________________________________
City and State __________________________
yes
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