NEW YORK CITY DEPARTMENT OF FINANCE G DIVISION OF LAND RECORDS G OFFICE OF THE CITY REGISTER APPLICATION TO CLAIM A REFUND Instructions: If you are requesting a Real Property Transfer Tax (RPTT) refund, please mail this application to: NYC Department of Finance, RPTT Unit, 345 Adams Street, 7th Floor, Brooklyn, NY 11201. All other refund requests should be mailed to: NYC Department of Finance, Office of the City Register, 66 John Street, 13th Floor, New York, NY 10038. Borough: Block: Lot: Transaction ID Number: Name of Applicant: Attorney or Representative (If Applicable): Address: City and State: Zip Code: Applicantʼs interest in the property listed above. Check the appropriate box: K K Owner K Title company K Attorney K Cancellation Other (Specify) ________________________________________________________________________________________ Amount of Refund Requested: $ ________________________________ Reason for Refund. Check the appropriate box: K K Overpayment K Double payment Other (Specify) ________________________________________________________________________________________ Name of Applicant: (Please print) Applicantʼs Signature: Title (If Corporate Officer): Phone Number: ________ ______ ___________ Date: / / ________ _______ ________ Attach copies of the cancelled checks, receipts, and cover pages showing payment of the charges to be refunded. Failure to submit the requested materials may delay the processing of your application. If the applicant is not the payer, the payer must complete the consent form on page 2. NOTE: REQUEST FOR A REFUND MUST BE MADE WITHIN ONE YEAR OF THE DATE OF PAYMENT. PLEASE ALLOW 6 TO 8 WEEKS FOR YOUR CLAIM TO BE PROCESSED. PLEASE DO NOT WRITE BELOW THIS LINE Total Amount of Overpayment $____________________________ Date Reviewed: Reviewed By: - F O R I N T E R N A L U S E O N LY Total Amount of Refund $ ____________________________ CR-100 Rev. 04/09/09 American LegalNet, Inc. www.FormsWorkflow.com Application To Claim A Refund - Payerʼs Consent PAYERʼS CONSENT TO RECEIVE A REFUND Page 2 Only complete this portion of the application if the person applying for the refund is different from the person who originally paid the filing or recording fee. Transaction ID: Borough: Party to receive the refund: Block: Lot: Address: City and State: Zip: I authorize the payment of the refund of recording or filing fees to be paid to the party named above. Name: Signature: Title: Date: American LegalNet, Inc. www.FormsWorkflow.com