Fillable RP-425-IVP Supplement to Form RP-425-E (TOWN OF BLOOMING GROVE)

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RP-425-IVP Supplement to Form RP-425-E (TOWN OF BLOOMING GROVE)

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RP-425-IVP
(7/19)
Property information
All owners of the property, and any owner’s spouse who resides on the premises, must provide their Social Security
numbers and sign the authorization below. Failure to do so will result in denial of the Enhanced STAR exemption.
Authorization
I (we) authorize the New York State Department of Taxation and Finance to annually verify, using my (our) Social Security
number(s) supplied below, whether my (our) income is less than or equal to the applicable annual income standard for
purposes of the Enhanced STAR exemption.
First owner information – Provide information for every owner, and any spouse even if not an owner.
First name and middle initial Last name Sufx
Social Security number Date of birth (mm/dd/yyyy) Is this your primary residence?
Yes No
Mark all that apply:
Owner *Spouse of an owner *Sibling of another owner
Name(s) and relationship(s) of spouse or sibling/owner:
Income information for rst year of application (see instructions):
Calculated income $ Tax year Income documentation (mark one below):
Federal Form 1040 NYS Form IT-201 Form RP-425-Wkst (see instructions)
Signature Date
(continues on page 2)
Property identication: Tax map number or section/block/lot
(see tax bill or assessment roll)
Location of property (street address) Unit number
City, town, or village State ZIP code
Contact name
Phone number Email address
Is this property held in a: *If yes, what is the legal name of the trust?
Trust? Yes * No
Life estate? Yes No
Department of Taxation and Finance
Ofce of Real Property Tax Services
Supplement to Form RP-425-E
Mandatory for all Enhanced STAR Applicants
When applying for the Enhanced STAR exemption, you must submit this form to your assessor along
with your Enhanced STAR application form and proof of income. For more information, see page 3.
* Provide name(s) of spouses and
siblings below.
For assessor’s use only
Municipal code 0 0 Ownership code
(Enter M or C if this property is a mobile home or a cooperative)
RP-425-IVP (7/19) Page 2 of 3
Additional owner or spouse information – Provide information for every owner, and any spouse even if not an owner.
Additional owner or spouse information – Provide information for every owner, and any spouse even if not an owner.
Additional owner or spouse information – Provide information for every owner, and any spouse even if not an owner.
First name and middle initial Last name Sufx
Social Security number Date of birth (mm/dd/yyyy) Is this your primary residence?
Yes No
Mark all that apply:
Owner *Spouse of an owner *Sibling of another owner
Name(s) and relationship(s) of spouse or sibling/owner:
Income information for rst year of application (see instructions):
Calculated income $ Tax year Income documentation (mark one below):
Federal Form 1040 NYS Form IT-201 Form RP-425-Wkst (see instructions)
Signature Date
* Provide name(s) of spouses and
siblings below.
First name and middle initial Last name Sufx
Social Security number Date of birth (mm/dd/yyyy) Is this your primary residence?
Yes No
Mark all that apply:
Owner *Spouse of an owner *Sibling of another owner
Name(s) and relationship(s) of spouse or sibling/owner:
Income information for rst year of application (see instructions):
Calculated income $ Tax year Income documentation (mark one below):
Federal Form 1040 NYS Form IT-201 Form RP-425-Wkst (see instructions)
Signature Date
* Provide name(s) of spouses and
siblings below.
First name and middle initial Last name Sufx
Social Security number Date of birth (mm/dd/yyyy) Is this your primary residence?
Yes No
Mark all that apply:
Owner *Spouse of an owner *Sibling of another owner
Name(s) and relationship(s) of spouse or sibling/owner:
Income information for rst year of application (see instructions):
Calculated income $ Tax year Income documentation (mark one below):
Federal Form 1040 NYS Form IT-201 Form RP-425-Wkst (see instructions)
Signature Date
* Provide name(s) of spouses and
siblings below.
Page 3 of 3 RP-425-IVP (7/19)
Instructions
You must include this form when applying or
reapplying for the Enhanced STAR exemption.
General information
To apply for the Enhanced STAR exemption, submit
this application and Form RP-425-E, Application for the
Enhanced STAR Exemption to your assessor.
You must also provide proof of income as described on
the above forms.
When submitting this form, you must supply the Social
Security numbers of all owners of the property and of any
owner’s spouse who resides on the premises.
In the rst year, the assessor will verify your eligibility
based on the income information you provide. (See
Income information.) In the following years, the New York
State Department of Taxation and Finance will verify your
income eligibility. You will not need to reapply for the
exemption or provide copies of your tax returns to your
local assessor.
The Tax Department will not disclose your income to the
assessor. It will only disclose whether or not your income
is below the applicable income standard.
Nassau County homeowners: Complete
Form RP-425-IVP along with the county’s Enhanced
STAR Property Tax Exemption Application,
which is available at Nassau County’s website at
www.nassaucountyny.gov (search: STAR). Submit
both forms to the address on page 2 of Nassau County’s
application.
Income information
This is the income that the assessor will use to verify your
eligibility in your rst year of applying for the Enhanced
STAR exemption.
• Calculated income – Refer to Proof of income for
STAR purposes on page 3 of Form RP-425-E for
instructions on how to calculate income.
• Tax year – Income is based on the tax year two years
prior to the year for which you are applying for an
exemption. For example, if you are applying for an
Enhanced STAR exemption for the 2020-2021 school
year, income is based on the 2018 tax year.
• Income documentation – Indicate the income tax form
that was used to document income. If you did not le
a Federal or New York State income tax return for the
required year, complete Form RP-425-Wkst, Income
for STAR Purposes Worksheet, and submit it with
Form RP-425-E and this form.
Privacy notication
The Privacy Act of 1974 requires us to advise you that
the law which allows us to ask for your Social Security
numbers is New York Real Property Tax Law section 425
(4)(b). It is mandatory that you furnish your Social
Security numbers. Once you furnish them, they will be
forwarded to the New York State Department of Taxation
and Finance, which will use them to verify, or attempt to
verify, whether your income is greater than the applicable
income standard for purposes of the Enhanced STAR
exemption. If you do not furnish your Social Security
numbers, you will be unable to receive an Enhanced
STAR exemption.
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RP-425-IVP Supplement to Form RP-425-E (TOWN OF BLOOMING GROVE)

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Completed 20 July 2020

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