Form Rp-485-A - Application For Real Property Tax Exemption For Residential-Commercial Urban Exemption Program

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RP-485-a (1/05)
NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE
OFFICE OF REAL PROPERTY TAX SERVICES
APPLICATION FOR REAL PROPERTY TAX
EXEMPTION FOR RESIDENTIAL-COMMERCIAL URBAN EXEMPTION PROGRAM
(Real Property Tax Law, Section 485-a)
(Instructions for completing this form are contained in Form RP-485-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
School district
City/Town
Village (if any)
Property identification (see tax bill or assessment roll)
Tax map number or section/block/lot
4. General description of property for which exemption is sought (if necessary, attach plans or
specifications):
5. Use of Property:
6. Describe alteration, installation or improvement made to convert the non-residential property to
mixed-use:
7. Cost of alteration, installation or improvement:
8. Date construction of alteration, installation or improvement was commenced:
9. Date completed (attach certificate of occupancy or other documentation of completion):

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