Form Tp 584 2 – Fill Out and Use This PDF

TP-584.2 (10/96)	Recording Office Time Stamp

Real Estate Transfer Tax Return

For Public Utility Companies’

and Governmental Agencies’

Easements and Licenses

This form may only be used by public utility companies regulated by the Public Service Commission and governmental agencies for the recording of easements and licenses where the consideration for the grant of such easement or license is $500.00 or less.

Name of grantee (public utility company or governmental agency)			Federal employer identification number
			(if applicable)
Address of grantee			Name and telephone number of person to contact
Name(s) of Grantor		Address of Property		Consideration Given
Of Easement or License				For Easement or License

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

If more than fifteen conveyances are to be recorded, attach a schedule of such other conveyances.

Signature of Grantee

I certify that the grantee is a public utility regulated by the Public Service Commission or is a governmental agency and the grantee of the easements and/or licenses above; that it is true to the best knowledge of the grantee that the granting of each such easement and/or license is exempt from Real Estate Transfer Tax imposed by Article 31 of the Tax Law by reason that each such conveyance is for a consideration of five hundred dollars or less and/or the conveyance is being made to a governmental agency.

Name of grantee

Signature of partner, officer of corporation, governmental official, etc.

Title