Fillable RP- 458-a Application for Alternative Veterans Exemption from (TOWN OF BLOOMING GROVE)

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RP- 458-a Application for Alternative Veterans Exemption from (TOWN OF BLOOMING GROVE)

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The RP- 458-a Application for Alternative Veterans Exemption from (TOWN OF BLOOMING GROVE) form is 2 pages long and contains:

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  • 60 other fields

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RP- 458-a
(2/19)
Department of Taxation and Finance
Ofce of Real Property Tax Services
Application for Alternative Veterans
Exemption from Real Property Taxation
See instructions, Form RP-458-a-I, for assistance in completing this form.
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 the branch of veteran’s service and dates of active service:
If Yes, attach written evidence.
6. Was the veteran discharged or released from 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 that service performed?
Attach written evidence.
8. Did the veteran receive 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 the rate was established.
Mark an X in the box if the 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? If Yes, attach written evidence ..................................................................................... Yes No
9. Is the property the primary residence of the veteran, unremarried surviving spouse of the veteran, or the
Gold Star parent? .................................................................................................................................................... Yes No
If No, is the veteran, unremarried surviving spouse of the veteran, or the Gold Star parent the owner
of the property and absent from the property due to medical reasons or institutionalization? ........................... Yes No
Explain:
1. Name(s) of owner(s)
2. Mailing address of owner(s)
(number and street or PO box) 3. Location of property (street address)
City, village, or post ofce State ZIP code City, town, or village State ZIP code
Daytime contact number Evening contact number Date of purchase of real property
E-mail address
Tax map number of section/block/lot: Property identication (see tax bill or assessment roll)
Name(s) of any non-owner spouse(s)
Address(es) of primary residence(s) if different from above:
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:
11. Date the title to this property was acquired:
/ /
. Attach copy of deed.
12. Has the owner(s) ever received, or is the owner(s) now receiving a veterans exemption based on
eligible funds on property in New York State? ......................................................................................................... Yes No
If Yes, the amount of eligible funds used in the purchase was ........................................................ $
Does that eligible funds exemption cover the same property listed on page 1? ...................................................... Yes No
If No, enter the location of this property in New York State:
If Yes, are you submitting this application only because you are seeking a school tax exemption?
(Check Yes if you want to apply for a new school tax exemption without having any changes made to
your existing eligible funds exemption; check No if you want your existing eligible funds exemption to
be replaced with the alternative veterans exemption.) ....................................................................................... Yes No
Page 2 of 2 RP-458-a (2/19)
Alternative veterans
exemption (RP-458-a)
Assessment TotalPeriod of war,
active service, or
expeditionary
medal recipient
(15% or ceiling
max.) approved
Yes No
Combat zone
service (including
expeditionary
medal) (10% or
ceiling max.)
approved
Yes No
Service connected
disability rating
(× 50%
or ceiling max.)
approved
Yes No
Village
Town/City
County
School district
For Assessor’s Use Only
Street address
Village City/Town School district
Certication
I (we) hereby certify that all statements made on this application are true and correct to the best of my (our) knowledge and belief and I
(we) understand that any willful false statement made herein will subject me (us) to the penalties prescribed in the Penal Law.
All owners must sign this application
Signature of owner(s) Date
Signature of owner(s) Date
Signature of owner(s) Date
Signature of owner(s) Date
Name of assessor
(please print)
Signature of assessor Date
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RP- 458-a Application for Alternative Veterans Exemption from (TOWN OF BLOOMING GROVE)

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Completed 20 July 2020

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