Elizabeth Hasensein
RPTL 730-A
UCS 9DDA (Rev.7/2008)
PETITION
SMALL CLAIMS ASSESSMENT REVIEW
IN COUNTIES IN NEW YORK CITY
(one oetition Der Darcel)
PART 1
GENERAL INFORMATION
SUPREME COURT, COUNTY OF j ,,/ jcjl,rj.-J.
Filing # Calendar #
1. Assessed valuation
(a) Total 3.(1, jc> C'
(b) Exempt amount -
(c) Taxable assessed value (1a-1b) .., ..- /./ ."
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2. Date of filing (or mailing) petition
3. Name of owner or owners of property: c: t, 2-'''~c7N /i:~ C--'~I 1 i:;')-../
Post Office Address: ,,- t-c.',.;: d/J k/I~:~"../\; td{ /~ /1// I 2 J?',,'
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Telephone #: ;j J' -.5.3 --
4. If applicable, name and address of representative of owner, if representative is filing application:
(Owner must complete Designation of Representative section.)
Telephone#:
5 Property information '],'-70] I J J.J 5?("
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Block Lot
Borough (Check one only)
Manhattan (1) 0 Bronx (2) 0 Brooklyn (3) 0 Queens (4) 0 Staten Island (5) 0
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Number ~,
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Street ..-.....1. / /.:'/-1
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RECEiVED
ASSESSOR'! OFFICE
JUL L7 2009
PART II
GROUNDS FOR PETITION
A. Assessment requested on the affidavit for correction with the Tax Commission:
1. Total assessment
2. Exempt amount, if any
3. Taxable assessment
B. CALCULATION OF EQUALIZED VALUE AND MAXIMUM REDUCTION IN ASSESSMENT
[] Calculation of Equalized Value.
ASSESSED VALUE
EQUALIZATION RATE
EQUALIZED VALUE
2.
[ ]
If the EQUALIZED VALUE exceeds $450,000, enter the ASSESSED VALUE here:
Multiply the ASSESSED VALUE by: x.25
Enter the result here:
The result is the maximum total assessment request reduction allowable.
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[ )
UNEQUAL ASSESSMENT: The total assessment is unequal because the property is assessed at a higher
percentage of full (market) value than (check one).
[ ] (a) the average of all other property on the assessment roll, or
[ ] (b) the average of residential property on the assessment roll.
Full (market) value of property: $
Based on one or more of the following, petitioner believes this property should be assessed at %
of full (market) value:
1. [ ] The latest State equalization rate for the assessing unit in which the property is located (enter latest
equalization rate: %).
2. The latest residential assessment ratio for the assessing unit in which the property is located (enter
residential assessment ratio: %).
3 A sample of market values of recent sales prices and assessments of comparable residential
properties on which petitioner relies for objection (list parcels on a separate sheet and attach).
4. [ Statements of the assessor or other local official that property has been placed on the roll at
%.
Petitioner believes the total assessment should be reduced to $ . This amount may
not be less than the total assessment amount indicated in Section A (1), or Section B (3), whichever
is greater.
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EXCESSIVE ASSESSMENT:
[~he total assessed value exceeds the full (market) value of the property.
Total assessed value of property: $ 3rf. IV0
Complainant believes the total assessment should be reduced to a full value of $ j l)<.J. {) l'l (I
Attach list of parcels upon which complainant relies for objection, if applicable.
This amount may not be less than the amount indicated in Section A (1), or Section B (3).
2 I ] The taxable assessed value is excessive because of the denial of all or a portion of a partial
exemption. Specify exemption (e.g., aged, clergy, veterans, etc).
Amount of exemption claimed: $ Amount granted, if any: $
may not be greater than the amount indicated in A (2).
If application for exemption was filed, attach a copy of application to this petition.
This amount
. E INFORMATION TO SUPPORT THE FULL (market) VALUE CLAIMED
1. Purchase price of property $
Date of purchase
Relationship, if any, between seller and purchaser
2 [ If property has been recently offered for sale:
When and for how long:
How offered:
Asking price: $
3. [
If property has been recently appraised:
When
Purpose of appraisal:
Appraised value: $
By Whom:
4. [ If buildings have been recently remodeled, constructed, or additional improvements made, state:
Year remodeled, constructed, or additions made:
Date commenced:
Cost: $
Date completed:
5. Amount for which your property is insured: $
Name of insurance company and policy number:
6. Information concerning properties recently sold:
ADDRESS
BLOCK
LOT
DATE
OF SALE
PURCHASE
PRICE
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PART III
DESIGNATION OF REPRESENTATIVE TO FILE PETITIOI\!
I, , as petitioner hereby designate
to act as my representative in any and all proceedings before the Small Claims Assessment Review of the Supreme
Court in County for purposes of reviewing the assessment of my rea I property as it appears
on the year assessment roll of the City of New York.
Signature of Owner
Date
PART IV
ELIGIBILITY AND CERTIFICATION
I certify that:
(a) The owner has previously filed a Application for Correction of Tentative Assessed Value.
(b) The property is improved by a Class 1 owner-occupied residential structure used exclusively
for residential purposes, and
(c) The requested assessment is not lower than the assessment requested on the Application for
Correction filed with the Tax Commission.
(d) If the equalized value of the property exceeds $450,000, the requested assessment
reduction does not exceed 25 percent of the assessed value.
I have mailed, by certified mail, return receipt requested, or, delivered in person, within ten days after the
day of filing this petition with the County Clerk, one (1) copy of this petition to the Real Property
Assessment Bureau of the City of New York.
I certify that all statements made on this application are true and correct to the best of my knowledge and
belief, and I understand that the making of any willful false statement of material fact herein will subject
me to the provisions of the Penal law relevant to t making and filing of false instruments.
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Check here if evening hearing is desired
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