2010 Application for School TAx Relief (STAR) Exemption

RP-425 A (6/09) New York State Board of Real Property Services City of Canandaigua Department of Assessments 2010 Application for School TAx Relief (STAR) Exemption Name and telephone number of owner(s) Mailing address of owner(s) Day Number ( Evening Number ( ) ) ¯ block Property Identification 320200 . Tax map number: section ¯ lot Street address All applicants must answer questions A& B: A. Is this property your primary residence? (Documentation is required!) Yes ____ No ____ **Failure to submit documentation will result in the denial of the STAR exemption.** B. Are you or your spouse currently receiving a School Tax Relief (STAR) exemption on any property in New York State? Yes ____ No ____ If yes, where is the property located? Property Address/Municipality Have you notified that municipality that you are changing your primary residence? Yes ____ No ____ Senior Citizen applicants may be eligible for additional benefits. Please answer questions 1 & 2: 1. Will all owners be at least 65 years of age as of December 31, 2010 OR is the property owned by a husband and wife (or by siblings) and will at least one spouse (or sibling) be 65 years of age as of December 31, 2010? Yes ____ No ____ 2. Is the total 2008 income of all the owners, and of any owners’ spouses residing on the premises, $74,700 or less? (See definition of income for STAR purposes on back of form). Yes ____ No ____ If the answer to both questions 1 and 2 is yes, all owners (including non-resident owners) must attach a copy of their 2008 New York State or federal income tax return (schedules and attachments are not routinely required). Individuals not required to file an income tax return must present documentation of income for the 2008 year. All owners must provide proof of age. I (we) certify that all of the above information is correct and that the property listed above is owned by me (us) and 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 and to provide any documentation of eligibility that is requested. All resident owners must sign and date. _________________________________________ Signature Date _________________________________________ Signature Date _________________________________________ Signature Date _________________________________________ Signature Date Caution: Misrepresentations of residency, age, or income on this application may subject the applicant to administrative and/or criminal penalties. Filing a false instrument in New York State is a felony offense. •• Return this form to the City Assessor on or before MARCH 1, 2010 •• GENERAL INFORMATION The New York State School Tax Relief (STAR) Program provides an partial exemption from school taxes for owner-occupied, primary residences. Senior citizens with combined 2008 incomes that do not exceed $74,700 may qualify for a larger “Enhanced” exemption. Senior citizens who would like to continue receiving Enhanced STAR in future years without having to reapply and submit copies of their NYS tax returns to their assessor every year are invited to sign up for the STAR Income Verification Program. Please see Form RP-425-IVP for more information. Seniors who do not choose to enroll in the IVP program must reapply each year to keep the Enhanced exemption in effect. If you are receiving the “Basic” exemption, you usually do not need to reapply in subsequent years, but you must notify the assessor if your primary residence changes. Application instructions: Print the name and mailing address of each person who both owns and primarily resides in the property. (If the title to the property is in a trust, the trust beneficiaries are deemed to be the owners for STAR purposes. Copies of the part of the trust identifying beneficiaries must be attached.) Residency New York State law does not provide a definition of primary residence. However, common indicators of primary residency can be found on driver's license, vehicle registration, voter registration, and NYS income tax return. Documentation supporting this address as your primary residence must be attached to this application. The parcel identification number may be obtained from either the assessment roll or the tax bill. Income for STAR purposes: Use the following table for identifying line references on 2008 federal and State income tax forms. You may NOT use your 2009 tax forms. Form # IRS Form 1040 IRS Form 1040A IRS Form 1040EZ NYS Form IT-201 NYS Form IT-150 Name of Form Income for STAR Purposes U.S. Individual Income Line 37 minus line 15b “Adjusted gross income” minus “taxable amount” of total IRA distributions Tax Return U.S. Individual Income Line 21 minus line 11b “Adjusted gross income” minus “taxable amount” of total IRA distributions Tax Return Income Tax Return for Line 4 only “Adjusted gross income” (no adjustment needed for IRA’s) Single and Joint Filers with No Dependents Line 18 minus line 9 Resident Income Tax “Federal adjusted gross income” minus “taxable amount of IRA distributions” Return Line 11 minus 5 Resident Income Tax “Federal adjusted gross income minus “taxable amount of IRA distributions” Return * * * * * * * * * * * * * * * * * * * * * * SPACE BELOW FOR USE OF ASSESSOR * * * * * * * * * * * * * * * * * * * * * * 320200 Tax map number: . section ¯ block ¯ lot Street address Application received Proof of age Proof of income Proof of residency Assessor’s signature ____________________ ____________________ ____________________ ____________________ ____________________________________ Approved Senior additional Yes _____ No ______ Yes _____ No ______ Date ______________________