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                         TAX COMMISSION OF THE CITY OF NEW YORK 
                                                                                                                   
                         1 Centre Street, Room 2400, New York, NY 10007                               TC109INS 
                                                                                                      2023/24 
                         2023/24 INSTRUCTIONS FOR FORM TC109                                                       
                                                                                                                   
                     APPLICATION FOR CORRECTION OF ASSESSED VALUE OF 
                     TAX CLASS TWO OR FOUR CONDOMINIUM PROPERTY 
                                                             
Read TC600 How to Appeal a Tentative Assessment              2023.  The deadline is set by law and cannot be waived 
before  you  begin  to  complete  this  form.  If  you  are  or extended for any reason.   
                                                              
representing yourself and are filing for a single unit (or 
                                                             Filing by mail.  Mail the completed Form TC109 to the 
two or more units that have been physically combined), 
                                                             Tax Commission, 1 Centre Street, Room 2400, New York, 
read TC109INS Supplemental before completing this 
                                                             NY 10007. DO NOT MAIL THE TC109 TO ANY OTHER 
form. 
                                                             ADDRESS. Applications received after the  March  2 
Who should use this form?  Condominium owners, or a  deadline  will not  be  accepted  even  if  they  were  mailed 
condominium board of managers acting as the agent of  before that  date.   Include a  self-addressed, stamped 
the condominium owners, should use this form to claim a      Tax Commission receipt Form TC10. 
                                                              
reduction of  the  2023/24  tentative  assessed value  of 
                                                             Filing in Person: Bring the completed Form TC109 to the 
condominium property in tax class two or four (including 
                                                             Tax Commission’s Manhattan office at 1 Centre St. or to a 
two-unit condominiums  and  condominiums owned by 
                                                             Finance Department Business Center in any borough by 
cooperative apartment corporations).  A single form may 
                                                             the deadline. Get a date-stamped receipt (Form TC10).  
include  one unit,  multiple units or all units  of a         
condominium, provided all units are on one tax map block.   A date-stamped Form TC10  is  the only acceptable 
 
                                                             proof  of  timely  filing.    Proof  of  mailing,  or  a  return 
What authorizes a condominium board of managers to 
                                                             receipt from the  post office  or  an  express delivery 
be an agent?  The authority of the condominium board of 
                                                             company, is not acceptable proof of timely filing with 
managers to file Form TC109 as the agent of a unit owner 
                                                             the Tax Commission.   
may be contained in (a) the condominium’s by-laws, (b) a      
power-of-attorney, or (c) an individual authorization valid  File an original. Keep a photocopy for your records and to 
under applicable law.  The Tax Commission will review  use  at  your  hearing.    See  TC600  for information  about 
only one Form TC109 for any given unit.  If the unit owner  filing additional copies. 
and the board each files separately for the same unit, they   
each will be notified that one of the applications must be   Applications  require an original signature and, 
withdrawn.                                                   therefore, may not be filed by fax or e-mail. 
                                                             Additional forms may be required to be submitted with 
Do not use this form to claim (a) an exemption or a  the application  in particular cases.   These are the 
change in tax class (use Form TC106), or (b) for a tax       additional forms most commonly required: 
                                                              
class one condo property (use Form TC108).   
                                                             TC200 Addendum to Application.  Form TC200 is required: 
                                                              
FEE FOR CERTAIN PROPERTIES.                                  •  If the Applicant is not i) the owner of the entire property, and 
A $175 fee is required for all applications where the         not ii) a tenant of the entire property who pays all taxes and 
assessed value on  the  notice of property value for          expenses of the property and who has the right to protest the 
2023/24 is $2 million or more.  If multiple condominium       assessment; 
units file on a single application, the fee will apply if the aggregate assessed value is $2 million  or                  If the Form TC109 is to be signed by a fiduciary; 
                                                              
more.  No fee is due if the Applicant or representative      •  If the Applicant answers “YES” to either question in part 8 of 
waives review of the application before it is scheduled       Form TC109 regarding sale, demolition or construction at the 
for review.  If  the  fee is unpaid,  review of your          property.  If a sale or contract of sale is between unrelated 
application may be denied and any offer of correction         parties, file Form TC230 instead of Form TC200.  
                                                              
revoked. The fee will be included on the Real Property        
Tax bill.   DO NOT PAY  THE FEE  WITH THIS                   NOTE: TC200 is no longer required to be filed for applicants 
APPLICATION.                                                 making valuation claims for  one or more individual 
 
                                                             residential or commercial units without regard to the value 
When and where to file.  The Tax Commission must 
                                                             of the entire condominium.  Complete Part 7 of TC109 
receive your application by 5:00 P.M. on  March  01, 



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instead.                                                         unit (or two or more units that have been physically 
 
                                                                 combined), you only need to complete Parts 1 through 8.  
TC201.  Income  schedule  –  rent-producing  properties. 
                                                                 When completing Part 6, complete only lines a through d 
Applicants filing for only one or two rented residential units 
                                                                 for “units  covered  by  application”  and  use  the  amounts 
may instead list the gross rental income or submit copies 
                                                                 from the worksheet on Form TC109INS Supplemental. 
of the leases.                                                    
 
                                                                 Part 1: Identify the property.  List all lots on one tax map 
TC203.  Income schedule – cooperative or condominium. 
                                                                 block covered by the application in the boxes and on the 
But if the condominium began operation after July 1, 
                                                                 lines provided.  Use a separate form for lots on a different 
2022, or if it is exclusively residential with six or fewer 
                                                                 tax map block.  Unless (a) only a single lot is covered, or 
units,  Form TC203  is not required.        Applicants for 
                                                                 (b) all lots are covered, list the covered lots on the range 
condominium units owned by a cooperative  apartment 
                                                                 lines provided.  A range is a sequence of consecutively 
corporation must also file Form TC203.  
                                                                 numbered lots, with no omissions other than those that 
TC208. Income schedule – hotel or motel. If the units are  actually are omitted on the assessment roll itself.  If one of 
partially rented Form TC201 also must be filed.                  the lots in a range is not included in the application, skip 
 
                                                                 over it by ending the range at the preceding lot and start 
TC214. Income schedule  –  department  stores, theaters          another range at the next covered lot.  If more space is 
and parking sites.  If  the  units  are  partially  rented  Form needed, attach additional sheets that use a similar format. 
TC201 also must be filed.                                         
 
                                                                 Part 5: Hearing request.  You  can ask to have an in-
TC230. Sale statement – sale, transfer or sale contract.         person hearing  at  the  Tax  Commission’s main  office  in 
 
TC244. All Applicants whose Form TC109 is signed by an           Manhattan at 1 Centre Street, or you can ask to have the 
agent must also file an Agent’s Statement of Authority and       application reviewed based only on the papers submitted 
Knowledge Form TC244.                                            with Form TC109. Check the box to the left of your choice. 
                                                                 Check only one box.  
TC309. Accountant’s certification                                 
                                                                 Part 7: Condo Unit  Description.    Part 7  must be 
The  table below summarizes  filing requirements for             completed when making a claim regarding one residential 
various types of claims relating to condo valuation.             or commercial unit (or two units operated as a single unit), 
 
     Applicant             Claim      Required Forms             if  the  claim  is  independent of the  valuation  of  the 
 Condo Board          All claims      TC109, TC203               condominium as a whole.   
                                                                  
 Coop-owned                                                      Part 8: Construction or major alteration.  Construction 
 condo unit (cond-    All claims      TC109, TC203               or major alteration includes any work that (a) increases the 
 op)                                                             enclosed floor area or  cubic content of a building, (b) 
 Class 2 or 4              Claim                                 renovates a substantially vacant building (c) converts the 
 owner-occupied       relating to            TC109               use of one or more floors, such as from office to residential 
 condo unit                unit only                             use, (d)  completes renovation, or  tenant installations 
 Class 2 or 4              Claim                                 affecting at least 25% of a building’s area, (e)  installs or 
 owner-occupied       relating to            TC109               replaces HVAC, elevators, electric wiring or plumbing, (f) 
 condo unit           entire condo                               replaces at least one of the exterior faces of the building, 
 Class 2, one or                                                 or (g) costs or is expected to cost an amount that equals 
                           Claim 
 more income-                         TC109, TC201 or            or  exceeds  the  tentative  total  actual  assessment  under 
                      relating to 
 producing condo                      copies of leases           review. 
                      units only                                  
 units 
                                                                 Demolition.  Demolition is any work involving the 
 Class 2, one or 
                           Claim                                 dismantling,  razing or  removal of all of a building or 
 more income-                         TC109, TC201 or 
                      relating to                                structure, or  the dismantling,  razing or removal of 
 producing condo                      copies of leases 
                      entire condo                               structural members, floors, interior bearing walls, and/or 
 units 
                                                                 exterior walls or portions thereof. 
 Class 4, one or                                                  
                                      TC109, TC201, 
 more income- 
                      All claims      TC208 or TC214, 
 producing condo 
                                      as applicable 
 units 
 Class 1 condo 
                      All claims             TC108 
 unit(s) 
Specific line-by-line instructions.  
If you are representing yourself and are filing for a single 

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                            TAX COMMISSION OF THE CITY OF NEW YORK 
                                                                                                      TC109INS 
                            1 Centre Street, Room 2400, New York, NY 10007                            SUPPLEMENTAL 
                                                                                                      2023/24 
                                                                                                       
                                  APPLICATION ON FORM              TC109 FOR 2023/24 
             SUPPLEMENTAL INSTRUCTIONS FOR CLASS 2 OR 4 CONDOMINIUM  
                            UNIT OWNERS REPRESENTING THEMSELVES 
FEE FOR CERTAIN PROPERTIES                                         income the property generates or  could reasonably 
A $175 fee is required for all applications where the              generate on the open market.  Therefore, we do not rely 
assessed value on the notice of property value for                 on sales prices for condominium units to establish their 
2023/24  is $2 million or  more.  If multiple                      value for assessment purposes.  
condominium units file on a single application, the                 
fee will apply if the aggregate assessed value is $2               To calculate  the  value  for assessment purposes,  an 
million  or  more.  No  fee  is  due  if  the  applicant  or       estimate  of  the  net  income  of  the  whole  building  is 
representative  waives  review  of  the  application               divided by the appropriate rate of return demanded by 
before  it is scheduled for  review.  If any  fee is               the market, according to the formula of “Yearly income 
unpaid, review of  your application may be denied                  minus operating expenses divided by Rate of Return = 
and any offer of correction revoked. The fee will be               Value”.  When the Tax Commission  reviews your 
included on the Real Property Tax bill.  DO NOT PAY                application, we determine whether the entire building’s 
THE FEE WITH THIS APPLICATION.                                     value is less than the value indicated by the total 
                                                                   assessed value of the building.  A review of your unit’s 
Understanding  your  assessment.    The  Finance                   assessed value may also consider  specific factors 
Department  is  in  the  best  position  to  explain  your         affecting your unit’s value, such as differences in size, 
assessment and to consider the circumstances both of               location or amenities.  
your  property  and  those  of  your  neighbors  for  the           
following  year.  Information  about  assessments  is              Evidence  of  total  rental  income  and  expenses  for 
available on the Finance Department website at                     comparable rental buildings  is necessary to 
https://www1.nyc.gov/site/finance/taxes/property.page.             establish value.  You must submit proof of the market 
                                                                   rental value  of your unit as of January 5,  2023  using 
The  criteria for  granting  a reduction  in the                   income and expenses  of  comparable rental  buildings. 
assessment.  The law  governing  the assessment of                 Those rental buildings should be comparable to yours in 
condominiums requires  that  they be valued as  if the             age, number and mix of apartments, number of floors, 
whole building were operated as rental property.  This is          and location.   
not a simple task.   It is preferable for the board of              
managers to  apply to correct the  assessment of the               Unit specific claims.  If you claim that the assessment 
entire condominium, but you may apply for your own unit            of your unit is substantially out of line with most other 
by the filing deadline regardless of whether the board             units  in  your  building  because  of  the  percentage  of 
has applied.   If both you and the board apply, you and            common interest assigned to your unit by the 
your board will receive a notice  that one  of the                 condominium declaration or the  Finance  Department 
applications  must  be  withdrawn.  Otherwise  neither             allocation  of  value,  provide  a  copy  of  the  relevant 
application will be  reviewed.   Check with your  board            portions of the condominium declaration, including any 
before the filing deadline.                                        amendments,  describing  the  property,  including  your 
                                                                   unit.   In addition to evidence of rental value of your 
You have the burden of showing that the assessed value             building and/or unit, the declaration may support your 
of your unit is too high.  You cannot prove that you are           claim. However, the Tax Commission cannot direct the 
entitled to a reduction in the assessed value of your unit         Finance  Department  to  change  its  allocation  formula.  
by  showing  that  assessments  of  other  units  in  your         We only can review and adjust the assessment for the 
building are lower or that your neighbors’ units are               year covered by your application.  
assessed at a lower percentage of the Finance Dept.’s               
estimated market value than yours is.  We cannot                   Unit owners who rent  their unit  must provide 
change the Finance Dept.’s estimated market value; we              documentary proof of rent income, such as the signed 
review only the assessed value.                                    lease and a copy of a rent check.  Owners who rent three 
                                                                   or more units may file Form TC201 instead of providing 
Income method of valuation. To prove your claim, it is             leases. 
important to understand the income method of valuation              
as it  applies  to your property.  Under the law,                  Potential sources of information.   The Tax 
condominium units in class two and four must be valued             Commission cannot advise you as to where to get rental 
using the income method as if they were rental property.           information or  advice or representation.  You  may 
The income method of valuation is based on the rental              choose to consult a local real estate broker, appraiser, 

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property tax advisor or attorney for information. You may       Evaluate your claim.  Look at your Notice of Property 
look at commercial real estate websites  such as                Value from  the Finance Department and use the 
streeteasy.com, trulia.com or zillow.com for comparable         worksheet below to see if you should file an application 
rents.  There are also commercial services  that obtain         with the Tax Commission. 
income and expense data from the Finance Department.    
                                                           
         WORKSHEET FOR CONDOMINIUM UNIT VALUATION FOR ASSESSMENT PURPOSES  
                                                            
Look at your Notice of Value from the Finance Department.  Find the “tentative assessment” and “estimated market 
value” and write them on Lines 1 and 2 below. 

1.  Tentative 2023/24 Assessment:                                               ____________________ 
2.  Estimated market value:                                                     _____________________ 
 
You must prove that your unit’s value for assessment purposes is less than line 2 
to get a reduction in the assessment.  Complete Lines 3 through 8 to calculate the 
approximate value of your unit for assessment purposes.  
 
3.  The amount of rent you earn or would earn from a tenant 
on the open market each month:                                                  ____________________ 
 
4.  Monthly common charges  
(do not include interest, depreciation or real estate taxes):                        ____________________ 
5.  Net monthly income (Line 3 minus Line 4):                                   ____________________ 
6.  Net annual income - Multiply Line 5 by 12 (months in a year):               ____________________ 
7.  Divide Line 6 by .14297* = the approximate market value of your unit 
for assessment purposes                                                         ____________________ 
          
8.  Compare the amount on Line 2 with the amount on Line 7 
If Line 7 is more than Line 2, an application would not be productive. 
If Line 7 is less than Line 2 go to the next step. 
 
9. Multiply Line 7 by 45% (.45)**:                                              ____________________ 
The amount on line 9 is what you claim the assessed value of your property should be.  Enter this amount on line c of 
part 6 of TC109 under “units covered by application”. 
  
 * This amount reflects a reasonable rate of return plus a factor for real estate taxes on class 2 properties. 
  
 ** The assessment ratio for class 2 and 4 properties is 45%, meaning that the assessed value is 45% of Finance’s estimated 
    market value.   

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                             TAX COMMISSION OF THE CITY OF NEW YORK        High Value 
                                                                                                                                                               
                             1 Centre Street, Room 2400, New                              York, NY 10007     Copy 
                                                                                                                                                                 TC109 
                                 APPLICATION FOR CORRECTION OF ASSESSED VALUE                                                                                  2023/24 

                                 OF TAX CLASS TWO OR FOUR                                    CONDOMINIUM PROPERTY 
 READ TC600 AND THE SEPARATE INSTRUCTIONS (TC109INS) BEFORE YOU BEGIN.  COMPLETE ALL PARTS OF THE FORM. 
  
 Answer ALL questions marked  .IF FILED AFTER MARCH 1, APPLICANT CLAIMS ELIGIBILITY FOR REVIEW BECAUSE FILING IS WITHIN 20 CALENDAR DAYS OF:        APPORTIONMENT NOTICE.    NOTICE 
 OF INCREASE BY THE DEPARTMENT OF FINANCE.  YOU MUST ATTACH A COPY OF THE NOTICE. 
 1. PROPERTY IDENTIFICATION - Describe covered lots accurately.  Lots cannot be added later.                                                                                               2023/24                         YEAR                            9 
BOROUGH (Bronx, Brooklyn, Manhattan, Queens or Staten Island)  BLOCK                      LOW LOT COVERED                      HIGH LOT COVERED         ASSESSMENT YEAR 
                                                                                                                                                               2023/24 
FULL ADDRESS OF PROPERTY (WITH ZIP CODE) 
                                                                                                                                                                                                                            
NAME OF CONDOMINIUM                                                                                                                               CONDOMINIUM NO. 
 
This application covers:     1.   A single lot only.               2.   The entire condominium.                 3.   All of the lots within a single range of lots.                    _____________                    BOROUGH 
4.   All of the lots within two or more ranges of lots; list ranges in numerical order across the page.  5.  Additional ranges listed on pages ____  
       From lot          To lot                           From lot              To lot                       From lot            To lot                         From lot          To lot 
1____________-__________              2_____________-__________             3____________-__________              4____________-__________ 
 
5____________-__________              6_____________-__________             7____________-__________              8____________-__________ 
 
9____________-__________            10_____________-__________           11____________-__________            12____________-__________                                                                                     
 2. APPLICANT - Complete Section A for application filed by board of managers or Section B for all other 
 applicants.  An agent cannot be the applicant in Section B.                                                                                                                              _________                        BLOCK 
A.    Board of managers designated as agent for owners of covered lots for purposes of contesting the assessment. 
             Type of designation:            A by-law                                Individual authorizations.  
  If designated by individual authorizations, does the board hold a valid, signed authorization for each owner of covered lots? _______ (Y/N)                                                                              
  Have any unit owners requested that the board not file for their units? ________(Y/N).  If yes, how many? _______ 
 
                                                                                                                                                                                          _______                          LOT 
B.  Name of Applicant: ___________________________________________________________________________________________________ 
Relation to Units: Check only one:   Owner of one or more units.    Cooperative apartment corp. (file TC203).    Other:              _____________________ 
 Describe location of unit(s) in building (floor(s)) ___________________________________   
 List any owner occupied units: ________________________________________                                                                                                                                                                 GROUP #          
 Describe use(s) of units (e.g. residential, office, retail): ________________________________________________________________________ 
 Approximate floor area of commercial space__________________ sq.ft., of which ground fl. __________sq.ft, basement ____________sq.ft. 
 If any of the units are rented or offered for rent, file TC201, 203, 208 or 214 as appropriate, or, if filing only for one or two residential units, list                               _________ 
gross rent received in 2022 $_____________ and attach copies of leases or other documentation. See TC109INS Supplemental. 
FOR SECTION B APPLICANTS:  IF YOU ARE MAKING A CLAIM SPECIFIC TO ONE OR TWO RESIDENTIAL UNITS AND UNRELATED TO 
THE VALUE OF THE CONDO AS A WHOLE, YOU MUST COMPLETE PART 7.  SEE INSTRUCTIONS. 
If filed after March 1, applicant claims eligibility for review because filing is within 20 calendar days of:                                                                                           TC109
 Apportionment notice.     Notice of increase by the Department of Finance.  You            must attach a copy of the notice. 
 3. REPRESENTATION - Complete this section even if you will represent yourself.                                                                                                                                             
 
PHONE NO.  (___________)    ______________-----______________                        FAX NO. (____________)    ______________-----_______________ 
NAME OF INDIVIDUAL OR FIRM TO BE CONTACTED                                                                                                        GROUP #, IF ANY 
 
MAILING ADDRESS                                                                                          EMAIL ADDRESS 
                                                                                                          
The person listed is:    Applicant      Attorney            Employee       or officer of owner entity named in 2B      Otherrepresentative 
 4. ATTACHMENTS - List all schedules and documents attached.  Number the pages.  
If the applicant is the board of managers of the condominium or a cooperative apartment corporation, submit 
Form TC203.  See instructions for Form TC109 as to necessary income schedules and attachments.   
                                                                                                                                                                                                                                                            
 5. HEARING REQUEST -  Check only one box.                                                                                                                                                
 Review on papers submitted without a personal hearing                               Personal hearing in Manhattan                                                                      
                                                                                                                                                                                          
 Hearings for class two and four condominiums are held in the Tax Commission’s Manhattan office only.                                                   DATE RECEIVED 

    Signer’s initials  _______ You must initial this page if you do not use a two-sided application form. 



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 6. CLAIMS 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:                                   Condominium as a whole                        Units covered by application 
a. Tentative actual assessment                                                a. $____________________                      a. $____________________ 
b. Applicant's estimate of market value                                       b. $____________________                      b. $____________________ 
c. Requested assessment = line b x 45% assessment ratio                       c. $____________________                      c. $____________________ 
 d. Number of tax lots                                                        d.  ____________________                      d.  ____________________ 
The applicant reserves the right to allege an assessment ratio lower than 45% and seek a lower assessment in a proceeding for judicial review. 
Do not use this form to claim unlawful assessment, misclassification, or full or partial exemption; use Form TC106 with TC200. 
 7. RESIDENTIAL CONDO UNIT DESCRIPTION as of January 5, 2023.  Complete this Part AND Part 8 if you are making a 
 claim specific to one or two residential unit(s) apart from the value of the whole condo. Attach or submit at the hearing 
 evidence of the value of the unit(s)using the income method of valuation explained in TC600 and TC109INS Supp.  It is 
 not necessary to complete Part 9 if you are making a claim specific to one or two residential units. 
PERCENT OF COMMON INTEREST          YEAR AND NATURE OF LAST PHYSICAL CHANGE OR MAJOR ALTERATION 
                                     
RESIDENTIAL SQUARE FOOTAGE          PATIO/TERRACE/BALCONY/ OTHER SPECIAL FEATURES     NUMBER OF BEDROOMS IF APPLICABLE        NO. OF PARKING SPACES ASSIGNED TO YOUR UNIT 
                                                                                                                              Indoor: _______                Outdoor: ________ 
 8. PROPERTY DESCRIPTION - Describe the units covered by this application only.  
 NUMBER OF BUILDINGS                 NUMBER OF STORIES  ABOVE GRADE    YEAR OF CONSTRUCTION 
                                                                        
 USES (residential, office, retail, hotel, loft, factory, warehouse, storage, garage, theater, etc.):                                           Lot  Numbers                   .
 FLOORS 3 ___ -         _________________________________________________________________________________________           _________________________________________ 
  
 SECOND FLOOR           _________________________________________________________________________________________           _________________________________________ 
  
 FIRST FLOOR             
 BASEMENTS              _________________________________________________________________________________________           _________________________________________ 
 OUTDOOR SPACE (        e.g. cell tower/telecom equipment, signage, generators) ____________________________________        _________________________________________ 
 After January 5, 2021, has there been any construction, demolition or major alteration work or have plans for demolition been filed with the Buildings Dept.?  
 Yes      No.   If YES, submit Form TC200. 
 9. APPROXIMATE GROSS FLOOR AREA AS OF JANUARY 5, 2023.  Describe the entire condominium. 
           Floor             All uses (above grade)                  Retail                     Garage                                               Offices 
 FLOOR 3 - _____                                  sq.ft.                      sq.ft.                                 sq.ft.                                                     sq.ft. 
 SECOND FLOOR                                     sq.ft.                      sq.ft.                                 sq.ft.                                                     sq.ft. 
 FIRST FLOOR                                      sq.ft.                      sq.ft.                                 sq.ft.                                                     sq.ft. 
 BASEMENTS                                                                    sq.ft.                                 sq.ft.                                                     sq.ft. 
 TOTAL AREA                                       sq.ft.                      sq.ft.                                 sq.ft.                                                     sq.ft. 
 Is any part of the condominium used for vehicle parking? (Y/N)  _____   If yes, number of: indoor spaces ________; outdoor spaces ________. 
 Is any part of the condominium used for other nonresidential purposes? (Y/N) ______    If yes, number of retail units ______ number of office units _______. 
 SIGNATURE AND OATH  
 This application must be signed by an individual having personal knowledge of the facts who is the Applicant, a fiduciary, an agent, or an officer of a corporation, a 
 general partner of a partnership or a member or manager of a limited liability company (LLC), which legal entity either is the Applicant or a general partner or 
 member or manager of the Applicant. See instructions. NOTE: Forms TC200, TC244 and/or a Power of Attorney may be required. If required and not attached 
 to this application, it will be dismissed.   
 Signer is (check one of boxes i-vii below):  If box (v) or (vi) is checked, Mark application “Special Counsel Review” on the top of page 1. 
 i   . The Applicant named in Part 2.  (check this box only if the Applicant is an individual)     
 ii.   Officer of corporate Applicant, or Board of Managers, named in Part 2. Signer’s Title __________________________________________   
 iii.  General partner of partnership Applicant named in Part 2.      
 iv.  Member or manager of, or individual officer of, LLC Applicant named in Part 2. Signer’s Title ________________________________  
 v.    An attorney, employee, property manager or other agent for Applicant named in Part 2           TC244 and a notarized power of attorney must be attached. 
 vi.   Fiduciary. Specify fiduciary’s relationship to Applicant __________________________            Form TC200 may be required. See TC200INS (instructions). 
      If signing as fiduciary for a corporation, partnership or LLC, enter name of entity: _______________________________________________  
 vii.  An officer, general partner, or member or manager of an entity that is the general partner, member or manager of the Applicant.  
     Enter name of entity, relationship to Applicant and signer’s title:   Name of entity ___________________________________________________________         
     Relationship to Applicant _________________________________________________  Signer’s Title __________________________________________   
 OATH I have read this entire application before signing below, including all relevant instructions, whether on this form or on another.  I am personally 
 responsible for the accuracy of the information provided on this application and on any attachments, and I certify that all such information is true and 
 correct to the best of my knowledge and belief.  I also understand that such information is subject to verification, is being relied upon by the City of 
 New York and that the making of any willfully false statement of material fact on this application or any attachments will subject me to the provisions 
 of the penal law relevant to the making and filing of false statements. 
  PRINT CLEARLY NAME OF PERSON SIGNING _______________________________________________________                                                                
 Signed: ___________________________________________________________Date _____________________                                                                
 The signer must appear and acknowledge the signature before a notary.                                                                                        
  
 Sworn  to before me (signature of notary): _________________________________________________________                                                NOTARY STAMP 
 County __________________________ State ___________________________  Date _________________ 
                                                                                                                                                              
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