(City, Town, Village or County)
(See Part Two on Page 2)
(Complete one or more)
(Parent-child, in-laws, siblings, etc.)
(Furniture, livestock, etc.; attach list and sales)
(Attach copy of listing agreement, if any)
Complainant should submit construction cost details where available.
(Check a or b)
(Check one or more and provide details below)
Check all that apply and explain below.
e.g. Senior Citizens, Veterans, School Tax Relief, (STAR)
(e.g. nonprofit organization)
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Read this agreement, and complete the corresponding fields below.
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