Ca Form 3549-A - Application For New Home / First-Time Buyer Credit - 2010

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CALIFORNIA .FORM

TAXABLE . . Y EAR

3549-A

Application for New Home / First-Time Buyer Credit

2010

Part I Type of Credit

Check the credit for which you are applying.

New Home Credit

First-Time Buyer Credit

If New Home Credit, did you request a reservation?

Yes

Part II Property Information

TYPE or PRINT CLEARLY

Address .of .Property .Sold

Parcel .Number

City

State

ZIP .Code

County

Part III Seller’s Information – New Home Credit only

Seller’s .name

FEIN .or .CA .Corp .no .

Secretary .of .State .(SOS) .file .number

SSN .or .ITIN

Address .(number .and .street, .suite, .room, .PO .Box, .or .PMB .no .)

City .

State ZIP .Code

Part IV Seller’s Certification – New Home Credit only

Perjury Statement

Under penalties of perjury, I hereby certify that the property is a single family residence that has never been previously occupied. I certify that the information

provided above, to the best of my knowledge and belief, is true and correct.

Seller’s signature: ___________________________________________________________________________ Date: __________________________

Seller’s contact name: ____________________________________________________ Telephone number: (________) ________ - ________________

Part V Escrow Information

1 Escrow number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 ____________________

2 Date escrow closed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 ____________________

/ .

MM .

DD .

YYYY

Escrow company name _____________________________________________________________________________

Contact person ____________________________________________________________________________________

Contact person telephone number (________) _________-_______________

3 Total Purchase Price . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 Will all the buyers, disregarding buyers on title for incidental purposes who do not have an ownership percentage, be living

in the home as their principal residence and if this is not a new home, do all the buyers also qualify as first-time buyers?

See instructions before checking the applicable box. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

Do not complete Line 5 if you checked “No” on Line 4.

5 Enter 5% (.05) of the Total Purchase Price (line 3) or $10,000, whichever is less. This is the total credit amount . . . . . . . . .

Do not complete Line 6 or Line 7 if you checked “Yes” on Line 4.

6 Enter the Qualified Purchase Price. See instructions to determine the Qualified Purchase Price. . . . . . . . . . . . . . . . . . . . . . . . . .

7 Enter 5% (.05) of the Qualified Purchase Price (line 6) or $10,000, whichever is less. This is the total credit amount . . . . . . . .

FAX completed form (Side 1 and Side 2) and the final settlement statement to: 916.855.5577

Side 1

8231103

FTB 3549-A

(NEW 2010) (REV 05-10)

For Privacy Notice, get form FTB 1131.