NYC DEPARTMENT OF FINANCE - EXEMPTIONS UNIT - NFP (CU) RENEWAL FORM N O T- F O R - P R O F I T G C O N T E M P L AT E D U S E Mail to: NYC Dept. of Finance, Exemptions Unit - NFP (CU), P.O. Box 3120 - Church Street Station, New York, NY 10008-3120 Organization Name: Applicantʼs Name: Mailing Address: Borough: Block: Lot(s): Use this form to renew your CONTEMPLATED USE not-for-profit exemption. If you should have any questions regarding this renewal form, please call 212-504-4080 or email us at commercialexemptions@finance.nyc.gov. If calling from outside of the five NYC boroughs, please call 212-NEW-YORK (212-639-9675). SECTION ONE In the space below, provide the name and telephone number of a person to contact for additional information or to provide access to the property for a physical inspection. CONTACT NAME RELATIONSHIP TO APPLICANT DAYTIME TELEPHONE NUMBER SECTION TWO The following questions pertain to changes which were not disclosed in a prior renewal form. Please answer the following questions by checking either YES or NO. FOR EACH QUESTION ANSWERED “YES”, ATTACH A SEPARATE SHEET AND PROVIDE A DETAILED EXPLANATION OF EACH CHANGE. 2a. A change has been made to the Articles of Incorporation or By-Laws of the organization. .......... 2b. A change has occurred in the organizationʼs status with regard to exemption from federal income tax. ......................................................................................................................................... 2c. A physical change has been made to the property in the form of new construction, alteration, or demolition. ................................................................................................................................ K K K YES YES YES K K K NO NO NO NFP-Renewal-Contemplated Rev. 8/31/09 American LegalNet, Inc. www.FormsWorkFlow.com Renewal Form - Not For Profit - Contemplated Use Page 2 SECTION THREE Provide a brief description of the current use of the property. If the use is still in the contemplated stage, your description should include the following: anticipated start and completion dates of construction; name of architect and construction firm retained for project; floor-by-floor description of each buildingʼs intended use; intended occupant(s); square footage or percentage of floor area of each occupant; and annual anticipated rental income from each tenant. (PLEASE USE ADDITIONAL PAGES IF NECESSARY.) ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________ SECTION FOUR SIGN AND DATE BELOW TO CERTIFY THE ACCURACY OF ALL INFORMATION YOU PROVIDED IN THIS FORM. I certify that all information contained in this application is true and correct to the best of my knowledge and belief. I understand that willful making of any false statement of material fact herein will subject me to the provisions of law relevant to the making and filing of false instruments and will render this application null and void. SIGNATURE TITLE DATE American LegalNet, Inc. www.FormsWorkFlow.com