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Pina & Chester R. Perine Jr RPTL 730 UCS 900 (Rev. March,2007) PETITION SMALL CLAIMS ASSESSMENT REVIEW IN COUNTIES OUTSIDE NEW YORK CITY (one petition per parcel) UPREME COURT, COUNTY 1. Filing # Calendar # AsSeSSingUnit~ ~\r .--p.d. I W~f'I5 FiL(I"i. NY /;?5-iJD Date of final completion and filing of assessment roll' I J 2. 3. 5. Name of owner or owners of property: V \ I\~ ~ C-he..stt'...r M. '&-"VO f'.L, Post Office Address: 31- --;t;,.... '"Bd./ \r1tt.pPi:jers ~t1sf f\J'II~s-1D .Telephone #: g +S - ~ .3,;l " I SO I (a) Total (b) Exempt amount (c) Taxable assessed value (3a-3b) 4. Date of filing (or mailing) petition 6. If applicable, name and address of representative of owner, if representative is filing application: (Owner must complete Designation of Representative section.) Telephone#: 7. Description of property as it appears on the assessment roll. Tax Map # 1.15~ Section (e ~5 1- Block ();t Lot '7 '33 9-1 '1 8. Location of property (street, road, highway number. and city, town or village) 2;'1-- lOr r\d, W~fPI2r~rs ~1I:s f rJ Y f.2S'{D r,.::: !"":-", .;".:::-, ....~1$ c , _~ \"1 1'>":> o ]-q -- :--) ~ ~-:.. """") -,j" REceIVED JUL 2 0 2Q(S TOWN CLERK N C-, PART II GROUNDS FOR PETITION A. Assessment requested on the complaint form filed with the Board of Assessment Review ~ ~1t, ~~ 1. 2. 3. Total assessment Exempt amount, if any Taxable assessment B. CALCULATION OF EQUALIZED VALUE AND MAXIMUM REDUCTION IN ASSESSMENT 1. [ ] Property is NOT in a special assessing unit. ASSESSED VALUE + EQUALIZATION RATE = EQUALIZED VALUE 2. [ ] Property IS in a special assessing unil ASSESSED VALUE + CLASS ONE RATIO = EQUALIZED VALUE 3. [ ] If the EQUALIZEQ. VALUE exceeds $450,000, enter the ASSESSED VALUE here: Multiply the ASSESSED VALUE by: Enter the result here: The result is the maximum total assessment request reduction allowable. x.25 c. [ ] UNEQUAL ASSESSMENT: The total assessment is unequal because the property is assessed at a higher percentage of full (marl<et) 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 (marl<et) value of property: $ Based on one or more of the following, petitioner believes this property should be assessed at % of full (mar1<et) value: 1. [ The latest State equalization rate for the assessing unit in which the property is located (enter latest equalization rate: %). 2. I 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. D. [ ] EXCESSIVE ASSESSMENT: 1. [ ] The total assessed value exceeds the full market) value of the property. Total assessed value-of property: $ ., . Complainant believes the total assessment sho Id be reduced to a full value of $ 3 10, Of) D Attach list of parcels upon which complainant relies for objection. if applicable. I This amount may not be less than the amount indicated in Section A (1), or Section B (3). 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, ete). Amount of exemption claimed: $ . Amount granted, if any: $ . This amount 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. 2. [ ] E. ".tNFORMATION TO SUPPORT THE FULL (MARKET) VALUE CLAIMED 1. [Vf Purchase price of propertY D Date of purchase ;l. I Relationship, if any, betwe n slier and purchaser n \)fU..,.., 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: By Whom: Purpose of appraisal: APpraised value: $ 4. [ ] If buildings have been recently remodeled, constructed, or additional improvements made, state: Year remodeled, constructed, or additions made: Date commenc8d: Date completed: Cost: $ 5. [~ Amount for which your property is insured: $ d Name of insurance company and policy number: A I-L..::rIA1E. po LI C Y .:tt q I 3 'il' ~ '13 T,;L 6. [ ~urchase price of comparable property(ies) recently sold: $ S'<.€...... OL--4-\-O....c..h~ PART III LISTING OFTAXING DISTRICTS Names of Taxina Districts 1. 2. 3. COUNTY: 1> \A- ~S TOWN tA!.~ p I AtleY' VILLAGE: ,J I f-t J SCHOOL DISTRICT WOffl''j er5 Cen+r.J 4. RPTL 730 PART IV DESIGNATION OF REPRESENTATIVE TO FILE PETITION I, , as petitioner (or officer thereof) 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 real property as It appears on the Signature of Owner (Or officer thereof) Date PART V ELIGIBILITY AND CERTIFICATION I certify that: . (a) The owner has previously filed a complaint required for administrative review of assessments. (b) The property is improved by a one, two or three family, owner-occupied residential structure used exclusively for residential purposes, and is not a condominium; except a condominium designated as Class 1 in Nassau County or as "homestead" Class in an approved assessing unit. (c) The requested assessment is not lower than the assessment requested on the complaint filed with the assessor or the Board of Assessment Review. (d) Ifthe equalized value ofthe property exceeds $450,000, the requested assessment reduction does not exceed 25 percent of the assessed value. (e) 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 clerk of the assessing unit, or if there by no such clerk, then to the officer who performs the customary duties of that official. (f) I have mailed by regular mail within 10 (ten) days after the filing of the Petition with the County Clerk one (1) copy of the Petition to: (a) The clerk ofthe school district(s)* within which the real property is located, or if there be no clerk or the name and address cannot be obtained, then to a trustee, (b) The treasurer of the county in which the property is located, and (c) The assessor, or, the chairman of the board of assessors 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 ~e ~. and filin alse instruments. Signature of owner or representative (*NOTE: You are not required to file with the Buffalo City School District, the Rochester City School District, the Syracuse City School District or the Yonkers City School District.)