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Get NYC SCRIE Tenant Ineligibility 2011-2024

SCRIE Docket 2. Name of Landlord Managing Agent a. b. FIRST NAME LAST NAME 3. Company Name 4. Borough Block Lot 5. Name of Tenant a. b. 6. Property Address NUMBER STREET NAME CITY 7. Daytime Phone Number STATE APARTMENT NUMBER ZIP CODE Extension 8. TM Finance SCRIE NYC DEPARTMENT OF FINANCE TAX AND PARKING PROGRAM OPERATIONS LANDLORD / MANAGING AGENT NOTIFICATION OF TENANT S INELIGIBILITY FOR THE SENIOR CITIZEN RENT INCREASE EXEMPTION PROGRAM G Mail to NYC Department of Finance Attn SCRIE 59 Maiden Lane 22nd Floor New York NY 10038 Faxed applications will not be accepted. Instructions This form is to be used as notification from landlord/managing agents of SCRIE tenants who are no longer eligible to receive SCRIE due to death move or approval for other housing benefits. Email Address 9. I request revocation of the above mentioned tenant from the SCRIE program based on choose reason below K It was reported to me that the Tenant passed away on K Tenant vacated the apartment and moved on / Date K Tenant approved for other housing benefits as of // Please attach copy of approval notice SECTION II - CERTIFICATION I understand that I may be debited any TAC Tax Abatement Credit issued to this property after the date of death move or date receiving other housing benefit and may now have charges due on my property tax bill for those tax periods previously satisfied. I affirm that the above facts are true and are given to the NYC Dept of Finance SCRIE Program to determine the effective date of the revocation of said SCRIE recipient s benefits. Signature of Landlord / Managing Agent If you have questions please contact scrie finance. nyc.gov or call 311. Name of Tenant a. b. 6. Property Address NUMBER STREET NAME CITY 7. Daytime Phone Number STATE APARTMENT NUMBER ZIP CODE Extension 8. Email Address 9. I request revocation of the above mentioned tenant from the SCRIE program based on choose reason below K It was reported to me that the Tenant passed away on K Tenant vacated the apartment and moved on / Date K Tenant approved for other housing benefits as of // Please attach copy of approval notice SECTION II - CERTIFICATION I understand that I may be debited any TAC Tax Abatement Credit issued to this property after the date of death move or date receiving other housing benefit and may now have charges due on my property tax bill for those tax periods previously satisfied. I affirm that the above facts are true and are given to the NYC Dept of Finance SCRIE Program to determine the effective date of the revocation of said SCRIE recipient s benefits. Please complete the information requested and submit within 30 days of death move or inclusion in other program to be compliant with the law governing SCRIE* SECTION I - APPLICANT INFORMATION 1. SCRIE Docket 2. Name of Landlord Managing Agent a* b. FIRST NAME LAST NAME 3. Company Name 4. Borough Block Lot 5. Name of Tenant a* b. 6. Property Address NUMBER STREET NAME CITY 7. Daytime Phone Number STATE APARTMENT NUMBER ZIP CODE Extension 8. .

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