Form Tc105 – Fill Out and Use This PDF

7. DESCRIPTION OF IMPROVEMENTS NOT PREVIOUSLY REPORTED TO THE FINANCE DEPARTMENT

YEAR BUILT OR INSTALLED

DESCRIPTON

ORIGINAL COST

8. CLAIM OF UNEQUAL OR EXCESSIVE ASSESSMENT

Applicant objects to the assessment on the grounds that it is (a) unequal or (b) excessive because the assessment exceeds the full value of the property or statutory limits on increases, as follows:

a.	Tentative actual assessment	$___________________________________
b. Applicant's estimate of market value		$___________________________________
c. Requested assessment = line b x 45% assessment ratio		$___________________________________
d. Market value of land as if unimproved (optional)		$ ___________________________________
e.	Market value added by new improvements during the two years ending January 5	$ ___________________________________

The applicant reserves the right to allege an assessment ratio lower than 45% and seek a lower assessment in a proceeding for judicial review of the assessment the applicant may commence.

Do not use this form to claim unlawful assessment, misclassification, or error in determining the amount of an exemption; use Form TC106 with TC200. Set forth information here in support of your market value estimate, attach statement of facts and other documents, or submit at the hearing.

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This application must be signed by an individual having personal knowledge of the facts who is the applicant or a fiduciary or an agent or an officer of a corporation or a general partner of a partnership or a member or manager of a limited liability company, which legal entity is the applicant or is a general partner or member or manager of the applicant. If an agent signs, attach a notarized power of attorney signed by the applicant and Form TC244, Agent's Statement of Authority and Knowledge. If a fiduciary, see Form TC600 for instructions on documentation of authority.

Print name of person signing ___________________________________ If signing as an officer, general partner or member or manager specify name

of entity and person's title.

Name of entity __________________________________________________________ Title _________________________________________

Singer or entity is:  The applicant.  General partner of partnership applicant.  Member or manager of limited liability company applicant.

An attorney, employee, property manager or other agent. A notarized power of attorney and Form TC244 must be attached.

I certify that all statements made on this application, including the attached sheet(s) totaling _____ pages, are true and correct

to the best of my knowledge and belief, and I understand that such statements are subject to verification. I also understand that the making of any willful false statement of material fact in this application including the attached sheet(s) will subject me to the provisions of the penal law relevant to the making and filing of false instruments.

Signed: __________________________________________________________Date:______________________

The signer must appear and acknowledge the signature before a notary.

Sworn to before me:

County __________________________ State ___________________________ Date _________________

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TC105