Town of Horseheads AND
Town of Big Flats Assessor's office.
(607) 739-0873
Please email completed form to:
assessor@townofhorseheads.org
> All Property Taxes must be Paid in Full.
> All Parcels must have the same deeded owners
> All Parcels must be in the same Municipality & School District
> All Parcels must be free of mortgages or be encumbered by a common mortgage.
> All Parcels must be adjacent.
> All Parcels within an agricultural district cannot be combined with parcels outside of an agricult
ural district.
Date:
Telephone: Day:
Eve:
Email:
Please list
Tax Map Numbers Location Description Deed Reference (Book & Page) Deed Date
each parcel 1)
separately 2)
on lines 3)
provided 4)
(Use Additional 5)
Sheet if 6)
Needed) 7)
I (We) the undersigned owners of the Real Property described above request that the above mentioned property be combined and I (We)
understand that the reversal of this merge may not be possible without consent of the local Planning Board. I (We) acknowledge that the
above stated requirements have been met and I (We) will hold the Chemung County Real Property Tax Service, as well as the above
stated municipality, harmless for any problems resulting from such merger. (Attach a separate sheet for additional signatures).
Signature of Owner: Date:
Signature of Owner: Date:
Please make any remarks, which may assist the Technician to do research, on the reverse side of this form. Also include any Surveys, Abstracts, Wills, Plots, Etc that may be applicable.
I (We) the undersigned Assessor(s) for the above state municipality find that the properties described above should be combined on the
following assessment roll as they are contiguous, and have common ownership. The Real Property Tax Service and its Mapping Division
are hereby authorized to combine the aforesaid parcels and assign one number to the resulting parcel. This acknowledgement makes no
claim to the effectiveness of the merger relating to local lot statue and is not a substitute for any local regulation or required board
approval process in affect
Suggested Parcel Number (with house/structure):
Assessor's Signature Date:
[ ] Unpaid Taxes Found Notes:
[ ] No Unpaid Taxes Found
[ ] All owners above are in title to all parcels listed [ ] All parcels are in the same municipality and school district
[ ] All parcels above are contiguous (adjoining and/or separated by road, railroad, or river/stream)
Tax Map Number T.B.K.A. ________________________________________ Reason for Denial:
Mapper's Signature ____________________________________________
Date _______________________
**Assessor- Do Not update/delete parels in RPS until you receive the updated data sheets from the Real Property Mapping Department.
PROPERTY OWNERS ACKNOWLEDGEMENT
ASSESSOR'S ACKNOWLEDGEMENT
FOR RPTS TAX MAPPING USE ONLY
All Owners MUST sign, so attach an additional sheet for the additional owners.
NOTE: All of the above needs to be completed in order for request to be reviewed and finalized.
Swis: School District
ASSESSOR/PROPERTY OWNER USE
AUTHORIZATION TO COMBINE PARCELS
TAX MAP NUMBERS TO BE COMBINED
Owner (If Different):
Owners Address:
Requested By:
City, State, Zip:
Municipality:
*Proof of each line item must
accompany this form.
click to sign
signature
click to edit
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click to sign
signature
click to edit
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click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
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