Form Rp-928-B - Application For Installment Payments For Real Property Owned By Recipients Of Supplemental Security Income

ADVERTISEMENT

New York State Board of Real Property Services
RP-928-b (9/96)
APPLICATION FOR INSTALLMENT PAYMENTS
FOR REAL PROPERTY OWNED BY
RECIPIENTS OF SUPPLEMENTAL SECURITY INCOME
1. Name and telephone no. of owner(s)
2. Mailing address of owner(s)
Day No.
(
)
Evening No. (
)
3. Location of property
Street address
County
City/Town
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
Section 1: GENERAL INFORMATION
4. Is the property the principal residence of a person who receives Supplemental Security Income (SSI)?
____Yes
____No
Is the SSI recipient the owner of the residence? ____Yes
____No
If answer to either question is no, do not complete the remainder of this form. The
property is not eligible for installment payment of taxes.
5. Name of SSI recipient: __________________________________________
Attach to this application a report from the Social Security Administration (Form SSA-2458)
issued within the preceding 60 days, showing that the above individual is receiving SSI payments.
I certify that all statements made above are true and correct.
Signature of Owner(s)
Date
(or Owner's Representative *)
* If an owner is physically unable to complete this form, it may be completed by his or her spouse, child
or parent, or by some other representative. Explain representative's relationship to the owner.
SPACE BELOW FOR COUNTY TREASURER'S USE
Date application filed ______________
Application approved _________________
Application disapproved _____________
Applicable tax roll _________________
Date
Signature of County Treasurer
If this application is approved, the applicant must submit it to the Collecting Officer together with the first
installment payment (see Instructions on back). Otherwise, the Collecting Officer may not accept installment
payments under this program.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Rp-485-b - Application For Real Property Tax Exemption For Commercial, Business Or Industrial Property - 1995 Form Rp-485-b - Application For Real Property Tax Exemption For Commercial, Business Or Industrial Property - 1995 Financial
Form Rp-485-b - Application For Real Property Tax Exemption For Commercial, Business Or Industrial Property Form Rp-485-b - Application For Real Property Tax Exemption For Commercial, Business Or Industrial Property Financial
Form Rp-489-d - Application For Real Property Tax Exemption For Subsidized Railroad Real Property Form Rp-489-d - Application For Real Property Tax Exemption For Subsidized Railroad Real Property Financial
Form Rp-485-e - Application For Real Property Tax Exemption For Real Property In An Empire Zone Form Rp-485-e - Application For Real Property Tax Exemption For Real Property In An Empire Zone Financial
Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property - 1995 Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property - 1995 Financial
Form Rp-421-h -application For Real Property Tax Exemption For Capital Improvements To Residential Property - 2004 Form Rp-421-h -application For Real Property Tax Exemption For Capital Improvements To Residential Property - 2004 Legal
Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property Financial
Form Rp-485-n - Application For Real Property Tax Exemption For Residential-commercial Properties In Certain Counties Form Rp-485-n - Application For Real Property Tax Exemption For Residential-commercial Properties In Certain Counties Financial
Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property Form Rp-421-f - Application For Real Property Tax Exemption For Capital Improvements To Residential Property Financial
Form Rp-421-ff - Application For Real Property Tax Exemption For Residential Capital Improvements In City Of Auburn (cayuga County) Form Rp-421-ff - Application For Real Property Tax Exemption For Residential Capital Improvements In City Of Auburn (cayuga County) Financial

Related Categories

Parent category: Financial
Download
Go