Department of Taxation and Finance                                                 For office use only

                   Real Estate Transfer Tax Claim for Refund

Name of claimant                                                       Name of representative or person to contact                                   Telephone number
                                                                                                                                                     (   )
­­­Social­Security­number­           Employer­identification­number­   Firm­name,­if­applicable

Address of claimant                                                    Address of person to contact 

City,­village,­or­post­office­       ­                State­ ZIP­code­ City,­village,­or­post­office­                                                State­ ZIP­code

Location of property conveyed (list each lot separately; attach additional sheets if necessary)
Address County

Address County

Date of transfer (mm/dd/yyyy)

                                                    1 Amount­of­tax­paid­by­claimant/assignor­ .....................................               1.
Refund assignment: If­the­refund 
is to be paid to someone other than                 2  Amount of tax due  ........................................................................ 2.
the person primarily liable for the 
tax,­mark­an­X in this box and see 
instructions on­back­ ............................  3 Refund requested (subtract line 2 from line 1)  ..................................           3.

Explanation:­Give­a­full­explanation­below,­including­all­facts­on­which­your­claim­is­based.­Attach­additional­pages­if­necessary,­and­submit­a­copy­
of­all­documentation­necessary­to­substantiate­your­claim.­In­addition,­if­the­Form­TP-584,­Combined Real Estate Transfer Tax Return, Credit Line 
Mortgage Certificate, and Certification of Exemption from the Payment of Estimated Personal Income Tax, was­filed­with­a­recording­officer­rather­
than­directly­with­the­Tax­Department,­submit­a­copy­of­the­receipt­provided­by­the­recording­officer­at­the­time­of­payment.

Certification:­I,­                                                     ,­the­claimant­named­above,­or­partner,­officer,­or­other­authorized­
representative­of­the­claimant,­certify­that­the­information­contained­in­this­claim­is­true­and­correct­to­the­best­of­my­knowledge,­that­no­prior­claim­
for­a­refund­of­the­whole­or­any­part­of­the­amount­on­line­3­has­been­filed,­and­that­no­part­has­previously­been­refunded­to­the­claimant­or­any­
assignee,­except­as­specified­herein.
­Signature­                                                  Title­or­relationship­to­claimant­                                                      Date

TP-592.2 (7/19)

TP-592.2 (7/19)­(back)
                                                           Instructions

Who must file this form                                                        Privacy notification
Any­person(s)­claiming­a­refund­of­the­real­estate­transfer­tax­paid­          The Commissioner of Taxation and Finance may collect and maintain 
pursuant­to­Tax­Law­Article­31­must­file­this­form­within­two­years­from­      personal­information­pursuant­to­the­New­York­State­Tax­Law,­including­
the date of payment.                                                           but­not­limited­to,­sections­5-a,­171,­171-a,­287,­308,­429,­475,­505,­
                                                                               697,­1096,­1142,­and­1415­of­that­Law;­and­may­require­disclosure­of­
Person to contact                                                              Social­Security­numbers­pursuant­to­42­USC­405(c)(2)(C)(i).
Please­note­that­any­person­named­as­the­person to contact on this             This information will be used to determine and administer tax liabilities 
form­may­be­contacted­for­purposes­of­obtaining­additional­information.­       and,­when­authorized­by­law,­for­certain­tax­offset­and­exchange­of­tax­
However,­naming­a­contact­person­does­not­constitute­granting­                 information­programs­as­well­as­for­any­other­lawful­purpose.
power­of­attorney,­and­we­will­not­disclose­information­to­that­person­
solely­because­they­have­been­listed­as­a­contact.­If­you­wish­a­              Information­concerning­quarterly­wages­paid­to­employees­is­provided­
representative­to­have­such­authority,­you­must­complete­and­submit­           to­certain­state­agencies­for­purposes­of­fraud­prevention,­support­
Form­POA-1,­Power of Attorney.                                                 enforcement,­evaluation­of­the­effectiveness­of­certain­employment­and­
                                                                               training­programs­and­other­purposes­authorized­by­law.
Person primarily liable for tax                                                Failure to provide the required information may subject you to civil or 
Real estate transfer tax (Form TP-584, Part 1, line 6)                         criminal­penalties,­or­both,­under­the­Tax­Law.
The­person­primarily­liable­for­the­payment­of­the­tax­is­the­grantor.­If­     This­information­is­maintained­by­the­Manager­of­Document­
the­grantor­fails­to­pay­or­is­exempt,­the­liability­shifts­to­the­grantee.    Management,­NYS­Tax­Department,­W­A­Harriman­Campus,­Albany­NY­
Additional tax (Form TP-584, Part 2, line 3)                                   12227;­telephone­(518)­457-5181.
The person primarily liable for the payment of the additional tax is the 
grantee.­If­the­grantee­fails­to­pay­or­is­exempt,­the­liability­shifts­to­the­
grantor.                                                                       Need help?

Refund assignment                                                                       Visit our website at www.tax.ny.gov
When a refund is to be paid to someone other than the person primarily                  •­ get­information­and­manage­your­taxes­online
liable­for­the­payment­of­the­tax,­you­must­submit­an­acknowledged­                     •­ check­for­new­online­services­and­features
assignment­or­an­affidavit­executed­by­the­person­primarily­liable­that­
clearly:
                                                                               Telephone assistance
•  states­the­purpose­for­assigning­the­refund,
•  describes­the­subject­matter­of­the­assignment­with­such­particularity­     Mortgage­and­Transfer­Tax­Information­Center:­ 518-457-8637
   as­to­render­it­capable­of­identification, and                              To­order­forms­and­publications:­              518-457-5431
•  states­the­unconditional­intent­of­the­person­primarily­liable­to­assign­   Text­Telephone­(TTY)­or­TDD­                   Dial­7-1-1­for­the     
   the refund.                                                                 ­ equipment­users­­               New­York­Relay­Service
Where to file
Mail­your­claim­to:­ NYS TAX DEPARTMENT
                     TDAB - REAL ESTATE TRANSFER TAX
                     W A HARRIMAN CAMPUS
                     ALBANY NY 12227-2996
Private delivery services
If­you­choose,­you­may­use­a­private­delivery­service,­instead­of­the­
U.S.­Postal­Service,­to­mail­in­your­form­and­tax­payment.­However,­
if,­at­a­later­date,­you­need­to­establish­the­date­you­filed­or­paid­your­
tax,­you­cannot­use­the­date­recorded­by­a­private­delivery­service­
unless­you­used­a­delivery­service­that­has­been­designated­by­
the U.S. Secretary of the Treasury or the Commissioner of Taxation 
and­Finance.­(Currently­designated­delivery­services­are­listed­in­
Publication­55,­Designated Private Delivery Services. See Need help? 
below­for­information­on­obtaining­forms­and­publications.)­If­you­
have­used­a­designated­private­delivery­service­and­need­to­establish­
the­date­you­filed­your­form,­contact­that­private­delivery­service­for­
instructions on how to obtain written proof of the date your form was 
given­to­the­delivery­service­for­delivery.

                                                                  For office use only
                         Audit report                                                              Approval
Amount allowed                                                                 Approved for payment
$                                                                              $
Interest­amount­                                  Interest­start­date­         Signature
$
Total refund                                                                   Title
$
Examiner                                          Date Date