Fillable RP-467-Rnw Renewal Application for Partial Tax Exemption for (Town of East Hampton)

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RP-467-Rnw Renewal Application for Partial Tax Exemption for (Town of East Hampton)

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U.S.A. forms for Town of East Hampton

BROWSE TOWN OF EAST HAMPTON (NY) FORMS

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RP-467-Rnw
(9/19)
Department of Taxation and Finance
Ofce of Real Property Tax Services
Renewal Application for Partial Tax
Exemption for Real Property of Senior Citizens
To be led with your local assessor by taxable status date.
Do not le this form with the Ofce of Real Property Tax Services.
This form may only be used to apply for the partial tax exemption for real property of senior citizens. It may not be used to apply for the
Enhanced STAR exemption, which is a separate exemption.
1 Property identication (see tax bill or assessment roll)
Tax map number or section/block/lot
2 Since ling your application last year, fully describe in the lines below any changes in:
a title to the property (due to death, addition or deletion of owner);
b legal residence or occupancy of the property (e.g. connement of owner in hospital or nursing home, divorce, legal separation or
abandonment by spouse); or
c use of residence for other than residential purposes (store, ofce, farm, etc.).
d Children of owners, tenants or leaseholders living on the premises attending public school grades pre-K-12; if so, give the name
and location of the school or schools, and state whether such child or children were brought into the property in whole or in
substantial part for the purpose of attending a particular school within the school district.
Mark an X in the box if there has been no change in items a, b, c, and d above ......................................................................
Explanation of changes that have occurred as indicated on line 2 (attach additional sheets if necessary).
3 Did the owner or spouse le a federal or New York State income tax return for the preceding year?
If Yes, attach a copy of the return(s) ...................................................................................................................... Yes No
Name of applicant(s)
Mailing address
(number and street or PO box) Location of property (street address)
City, village, or post ofce State ZIP code City, village, or post ofce State ZIP code
Daytime contact number Evening contact number
Email address
(optional) School district
(continued)
COVID RENEWAL PROCEDURE
All Renewals should be mailed. The office is not accepting any walk-ins. Renewals can also be
placed in the drop box outside our Suite at 300 Pantigo Place, Ste 108, East Hampton NY 11937.
Please submit your 2020 Federal Income tax return and 1099 SSA no later than 4/15/2021
ASSESSOR PH: 631-324-4187 ASSESSOR FAX: 631-324-4643
Page 2 of 2 RP-467-Rnw (9/19)
4a Total income of owner(s) and spouse(s)
(add all income sources) .......................................... 4a
4b Of the income on line 4a, how much, if any, was used to pay for an owner’s care in a
residential health care facility? Attach proof of amount paid; enter 0 if not applicable
(see instructions) ..................................................................................................................... 4b
4c Subtract line 4b from line 4a ................................................................................................ 4c
5 If a deduction for unreimbursed medical and prescription drug expenses is authorized by
any of the municipalities in which property is located (contact assessor for information),
complete the following:
5a Unreimbursed medical and prescription drug costs
(be sure to deduct any amounts
reimbursed by insurance) ......................................................................................................... 5a
5b Subtotal income of owner(s) and spouse(s) (line 4c minus line 5a) ................................... 5b
6 If a deduction for veteran’s disability compensation is authorized by any of the municipalities
in which the property is located, complete the following:
Veteran’s disability compensation received. Attach proof; enter 0 if not applicable ................. 6
7 Total income of owner(s) and spouse(s) (line 5b subtotal minus line 6) ..................................... 7
8 Certication
I (we) certify that all statements made on this application are true and correct to the best of my (our) belief. I (we) understand that
any willful false statement of material fact will be grounds for disqualication from further exemption for a period of ve years, and a
ne of not more than $100.
Signature
(If more than one owner, all must sign)
Marital status Phone number Date
This Area for Assessor’s Use Only
Assessor’s signature Date
Date renewal application led Approved Disapproved
Exemption applies to taxes levied by or for: City/Town % County %
School % Village %
Names of owner(s) and spouse(s) Source of income Amount of annual income
4 Provide the income of each owner and spouse of each owner for the calendar year immediately preceding the date of application,
except for an owner who is absent from the residence due to divorce, legal separation, or abandonment. Attach additional sheets if
necessary. See Form RP-467-I, Instructions for Form RP-467, for income to be included.
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RP-467-Rnw Renewal Application for Partial Tax Exemption for (Town of East Hampton)

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Completed 13 February 2021

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