RP-425 (9/97) New York State Board of Real Property Services APPLICATION FOR SCHOOL TAX RELIEF (STAR) EXEMPTION (See instructions on back ) 1. Name and telephone no. of owner(s) 2. Mailing address of owner(s)
Day No. ( ) Evening No. ( ) 3. Location of property
Street address Village (if any)
City/Town School district Property identification (see tax bill or assessment roll) Tax map number or section/block/lot
4. Income information: ONLY for senior citizens who seek additional(enhanced) exemption If all of the owners are at least 65 years of age (or, for property owned by husband and wife, if one of the owners is at least 65 years of age) and the total income does not exceed $60,000, enter the total income ______. Attach a copy of the latest federal or New York State income tax return if filed and proof of age.
5. Certification (All resident owners must sign) I (we) certify that all of the above information is correct and that the property listed above is my (our) primary residence. I (we) understand it is my (our) obligation to notify the assessor if I (we) relocate to another primary residence. Date Signature
NOTE: This application must be filed with your local assessor. Do not file this form with the State Board of Real Property Services.
SPACE BELOW FOR USE OF ASSESSOR Application received ______Approved _____ Yes _____ No Proof of age ______Senior additional Proof of income ______Yes _____ No
Assessor 's signature Date RP-425 (9/97) GENERAL INFORMATION Page 2