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RP-467 (7/18) Department of Taxation and Finance Office of Real Property Tax Services Application for Partial Tax Exemption for Real Property of Senior Citizens For help completing this application, see Form RP-467-I, Instructions for Form RP-467. You must file this application with your local assessor by the taxable status date. Do not file this form with the Office of Real Property Tax Services. New for 2019. This form no longer serves as the application for the Enhanced STAR exemption. 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. To apply for the Enhanced STAR exemption, you must file Forms RP-425-E, Application for Enhanced STAR Exemption for the 2019-2020 School Year, and RP-425-IVP, Supplement to Forms RP-425-E and RP-425-Rnw, with your assessor by taxable status date. You may obtain those forms from your assessor or download them from www.tax.ny.gov. Note: If you do not already have a STAR exemption you may not apply for a new STAR exemption, but you may be eligible for a STAR credit, which is provided in the form of a check. For more information about the STAR credit, visit www.tax.ny.gov/STAR or call [PHONE REDACTED]. Name(s) of owner(s) Mailing address of owner(s) (number and street or PO box) Location of property (street address) City, village, or post office State ZIP code City, town, or village State ZIP code Daytime contact number Evening contact number School district E-mail address Tax map number of section/block/lot: Property identification (see tax bill or assessment roll) Name(s) of any non-owner spouse(s) Address(es) of primary residence(s) if different from above: 1 Indicate which documents you included with this application as proof of age of owners (see instructions): Driver license Birth certificate Other (specify) 2 Date you acquired ownership of property (see instructions): 3 Indicate document included with application as proof of ownership (see instructions): Deed Other (specify) 4 Do all the owners of the property presently occupy the premises as their legal primary residence? Yes No 4a If the answer to 4 is No, is an owner receiving medical care as an in-patient in a residential health care Yes No 4b If the answer to 4a is Yes, specify name and location of the facility: 4c If the answer to 4 is No, is the non-resident owner the spouse or former spouse of the resident owner?.... Yes No 4d If the answer to 4c is Yes, is he or she absent from the residence due to divorce, legal separation,or abandonment? Yes No 5 Is any portion of the property used for other than residential purposes (commercial, professional office, etc.)? Yes No 5a If answer is Yes, explain such use and describe the portion that is so used. ---PAGE BREAK--- Page 2 of 3 RP-467 (7/18) 6 List the income of each owner and spouse of each owner for the calendar year immediately preceding date of application. Attach additional sheets if necessary. (See instructions for income to be included.) 7 Of the income specified in line 6c 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) 7 7a Total income of owner(s) and spouse(s) (subtract line 7 from line 6c) 7a 8 If a deduction for unreimbursed medical and prescription drug expenses is authorized by any of the municipalities in which the property is located (see instructions), complete the following: 8a Unreimbursed medical and prescription drug costs (deduct any amounts reimbursed by insurance). 8a 8b Total income of owner(s) and spouse(s) (subtract line 8a from line 7a) 8b 9 If a deduction for veteran’s disability compensation is authorized by any of the municipalities in which the property is located, complete the following (see instructions): 9a Veteran’s disability compensation received (attach proof, enter 0 if not applicable) 9a 9b Total income of owner(s) and spouse(s) (subtract line 9a from line 8b) 9b Name of owner(s) Source of income Amount of income Name of spouse(s) if not owner of property Source of income of spouse(s) Amount of income of spouse(s) 6b Total income of spouse(s) 6b 6c Total income of owner(s) and spouse(s) (add line 6a and line 6b) 6c 6a Total income of owner(s) 6a 10 Did the owner or spouse file a federal or New York State income tax return for the preceding year? Yes No If answer is Yes, attach copy of such return or returns (see instructions). 11 Does a child (or children), including those of tenants or lessees, reside on the property and attend a public school, grades pre-K through 12? Yes No 11a If the answer to 11 is Yes, list name and location of school(s): 11b If the answer to 11 is Yes, was the child (or were the children) brought into the residence in whole or in substantial part for the purpose of attending a particular school within the school district? Yes No ---PAGE BREAK--- RP-467 (7/18) Page 3 of 3 I (we) certify that all statements made on this application are true and correct to the best of my (our) belief and I (we) understand that any willful false statement of material fact will be grounds for disqualification from further exemption for a period of five years, and a fine 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 Date application filed Proof of age submitted Proof of ownership submitted Proof of income submitted Application approved Application disapproved Exemption applies to taxes levied by or for: Town % County % School % Village % Assessor’s signature Date ---PAGE BREAK--- RP-425-E (7/18) Department of Taxation and Finance Office of Real Property Tax Services Application for Enhanced STAR Exemption for the 2019-2020 School Year You must submit Form RP-425-IVP, Supplement to Forms RP-425-E and RP-425-Rnw, with this form. For help completing this form, see the instructions on page 2. Attach additional sheets if necessary. Name(s) of owner(s) Mailing address of owner(s) (number and street or PO Box) Location of property (street address) City, village, or post office State ZIP code City, town, or village State ZIP code Daytime contact number Evening contact number School district E-mail address Tax map number of section/block/lot: Property identification (see tax bill or assessment roll) Name(s) of any non-owner spouse(s) Address(es) of primary residence(s) if different from above 1 Did you have a STAR exemption on this property for the 2015-2016 school year? Yes No If No, you are not eligible for the Enhanced STAR exemption. However, you may be eligible for the Enhanced STAR credit. Register at www.tax.ny.gov/star/ 2 Will all owners be at least 65 years of age as of December 31, 2019, or if the property is owned by a married couple or by siblings, will at least one of the spouses or siblings be at least 65 years of age as of December 31, 2019? Yes No 3 Is the total 2017 combined income of all the owners, and of any owners’ spouses residing on the premises, $86,300 or less? (See Income for STAR purposes on page Yes No Note: If the answer to both questions 2 and 3 is Yes, you must attach a copy of the 2017 federal or 2017 state income tax returns for all owners, including nonresident owners. If your assessor needs tax schedules and tax form attachments they will contact you. The assessor may also require proof of age. If you weren’t required to file a federal or New York State income tax return for 2017, submit Form RP-425-Wkst, Income for STAR Purposes Worksheet, to the assessor. If the answer to either of questions 2 and 3 is No, then you do not qualify for the Enhanced STAR exemption, but may continue to receive Basic STAR. 4 Do you or your spouse own another property that is either receiving a STAR exemption in New York State or a residency-based tax benefit in another state, such as the Florida Homestead exemption? Yes No If Yes, then you do not qualify for the Enhanced STAR exemption on this property. Return this form with Form RP-425-IVP to your local assessor by taxable status date (see Deadline on page Signature Date Signature Date Certification Caution: Anyone who misrepresents his or her primary residence, age, or income: • will be subject to a penalty of the greater of $100 or 20% of the improperly received tax savings • will be prohibited from receiving the STAR exemption for six years, and • may be subject to criminal prosecution. I (we) certify that all of the above information is correct, that I (we) own the property listed above and it is my (our) primary residence and that my (our) 2017 income was less than $86,300. I (we) understand it is my (our) obligation to notify the assessor if I (we) relocate to another primary residence and provide any documentation of eligibility that is required. All resident owners must sign and date this form. ---PAGE BREAK--- Page 2 of 2 RP-425-E (7/18) Instructions New for 2019 You must submit Form RP-425-IVP with this form when applying for the Enhanced STAR exemption. General information The Enhanced New York State School Tax Relief (STAR) exemption reduces the school tax liability for qualifying senior citizens by exempting a portion of the value of their home from the school tax. To qualify, the home must be: • owner-occupied, and • the homeowners’ primary residence. The combined 2017 income of the owners and spouses who reside on the property must not exceed $86,300 and you must have had a STAR exemption on the same property for the 2015-2016 school year. Deadline: You must file this application and Form RP-425-IVP with your local assessor on or before the applicable taxable status date, which is generally March 1. • In Westchester towns it is either May 1 or June 1; • In Nassau County it is January 2; • In the Villages of Bronxville and Kiryas Joel it is January 1; and • In cities, check with your assessor. For further information, ask your local assessor. Visit our website or your locality’s website to find your local assessor’s contact information. Do not file this form with the New York State Department of Taxation and Finance or the Office of Real Property Tax Services. Application instructions Print the name and mailing address of each person who owns the property, including any non-resident owners. (If the title to the property is in a trust, the trust beneficiaries Form number Title of income tax form Income for STAR purposes IRS Form 1040 U.S. Individual Income Tax Return Line 37 minus line 15b adjusted gross income minus taxable amount (of total IRA distributions) IRS Form 1040A U.S. Individual Income Tax Return Line 21 minus line 11b adjusted gross income minus taxable amount (of total IRA distributions) IRS Form 1040EZ Income Tax Return for Single and Joint Filers With No Dependents Line 4 only adjusted gross income (No adjustment needed for IRAs.) NYS Form IT-201 Resident Income Tax Return Line 19 minus line 9 federal adjusted gross income minus taxable amount of IRA distributions are deemed to be the owners for STAR purposes.) There is no single factor which determines whether the property is your primary residence, but we consider factors such as utility bills, voting and automobile registrations, and the length of time you occupy the property each year. The assessor may ask you to provide proof of residency and ownership. For the enhanced exemption, proof of age may also be required. You can find the parcel identification number on either the assessment roll or your tax bill. Income for STAR purposes Use the following table to identify the line references on 2017 federal and state income tax forms. Do not use your 2018 tax forms. If you weren’t required to file a federal or New York State income tax return for 2017, complete Form RP-425-Wkst, Income for STAR Purposes Worksheet, and submit it to the assessor along with this form and Form RP-425-IVP. This Area for Assessor’s Use Only Date application received: Proof of age: Yes No Proof of income: Yes No Proof of residency: Yes No Form RP-425-IVP received: Yes No Approved: Yes No Assessor’s signature Date ---PAGE BREAK--- Department of Taxation and Finance Office of Real Property Tax Services Supplement to Forms RP-425-E and RP-425-Rnw Mandatory for all Enhanced STAR Applicants RP-425-IVP (7/18) When applying or reapplying for the Enhanced STAR exemption, you must submit this form to your assessor along with your initial or renewal Enhanced STAR application form, whichever is applicable, and proof of income. For more information, see page 2. 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 greater than the applicable annual income standard for purposes of the Enhanced STAR exemption. Property identification: 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 Location of property Authorization First name Last name Social Security number Signature M.I. Please print the names of all owners and resident spouses 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. For assessor’s use only 6-digit muni code Ownership code (Enter M or C if this property is a mobile home or a cooperative) ---PAGE BREAK--- Page 2 of 2 RP-425-IVP (7/18) Instructions New for 2019 You must include this form when applying or reapplying for the Enhanced STAR exemption. General information To apply or reapply for the Enhanced STAR exemption, submit this application and the appropriate form below to your assessor: • Form RP-425-E, Application for the Enhanced STAR Exemption for the 2019-2020 School Year, or • Form RP-425-Rnw, Renewal Application for Enhanced STAR Exemption for the 2019-2020 School Year. You must also provide proof of income as described on the above forms. Note: Only senior citizens who were previously receiving the Basic STAR exemption are eligible to submit Form RP-425-E. 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 first year, the assessor will verify your eligibility based on the income information you provide. 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. Participants are not required to reapply annually for the exemption but are requested to advise the assessor if the property is no longer their primary residence or if the ownership of the property has changed. 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 (search: STAR). Submit both forms to the address on page 2 of Nassau County’s application. Privacy notification 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 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.