UCS 901 (Rev. 2005) R PT L 730 D E C IS IO N O F H E AR IN G O F FIC E R Prepare in triplicate. C om plete within 30 days of date of hearing. Send one copy to the petitioner's representative or the petitioner if not represented, one copy to the Individual representing the assessing jurisdiction and one copy to the assessm ent review clerk. D ate hearing held ________________ Date decision subm itted to clerk ________________ P AR T I-C AS E ID EN TIFIC ATIO N Suprem e Court, C ounty of:__________________ Filing #________________ C alendar #___________________ N am e of owner or owners: ____________________________________________________________________________________ Address:___________________________________________________________________________________________________ C ity/State/Zip Code:__________________________________________________________________________________________ Assessing Unit:______________________________________________________________________________________________ Tax M ap#_____________ Section_______________ Block_________________ Lot______________ P AR T II - D EC IS IO N D ISP O S ITION - Check 1, 2, 3, 4 or 5 1. ( ) D isqualified (check appropriate box below ) a. ( ) M ore then three fam ily b. ( ) N ot owner~occupied c. ( ) Property not used exclusively for residential purposes d. ( ) C ooperative e. ( ) C ondom inium , other than a condom inium designated as C lass I in N assau C ounty or as a "hom estead" in an approved assessing unit f. ( ) O ther, state reasons ___________________________________________________________________________________ g. ( )D id not file within 30 days of filing of final roll h. ( ) D id not file with Board of Assessm ent R eview N O T IC E O F D IS Q U ALIFIC ATIO N AN D R IG H T TO JU D IC IAL R E V IE W [ ] If num ber 1a through 1f is checked, above, this petition did not qualify for review under the Sm all C laim s Assessm ent R eview Program . Pursuant to section 730 of the Real Property Tax Law, you m ay seek judicial review w ithin 30 days of receipt of this notice. FINAL ASSESSMENT ROLL 2. [] 3. [] 4. [] 5. [] CLAIMED ASSESSMENT DECISION BY HEARING OFFICER $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $______________ N o change Taxable $ ______________ $______________ In assessm ent A ssessm ent Settled pursuant to an agreem ent of both parties. $ ______________ $_______________ $ ______________ U nequal Assessm ent Excessive Assessm ent Total Assessm ent Exem pt Am ount $_______________ CO STS AW ARD OF CO STS (C heck if applicable) [ ] Costs of $ ___________ are awarded to the petitioner, to be paid by the assessing unit. Note to Hearing Officer: If the decision reduces the assessm ent by 50 per cent or m ore of the claim ed reduction in assessm ent, you M U S T award costs of $30.00. If the decision reduces the assessm ent by less than 50 per cent of the claim ed reduction in assessm ent, you M AY award costs of up to $30.00. N O TIC E O F R EQ U IR ED AC TIO N BY AS SE SS IN G AN D TAX IN G JU R IS DIC TIO N S [] This decision grants your petition in whole or in part. The assessm ent will be changed, If possible, before the levy of taxes. or a refund of taxes will be m ade within 90 days of the date of this decision. Attached is a list of the nam e(s) of the person(s) or departm ent(s) in this county responsible for taking this action. C om pare the nam es of the taxing jurisdictions listed in PA R T III of your petition with the nam e(s) listed in the attachm ent to determ ine the appropriate person(s) or departm ent (s) to be contacted, if the need arises. State on the reverse side the findings of fact concerning the assessm ent, and the basis for your decision. Nam e and Address of H earing Officer ______________________________________________ ______________________________________________ ______________________________________________ Signature____________________________________________ American LegalNet, Inc. www.USCourtForms.com UCS 901 (Rev. 2005) R PT L 730 R EP O RT (C ontinued) ________________________________________________________________________________________________________________________________ American LegalNet, Inc. www.USCourtForms.com