Property Tax Postponement Claim Form 2008 - California Page 2

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On lines 21-32 enter your income for the 2007 calendar year. If applicable, include the income of your spouse or
registered domestic partner. On line 29 enter the total income of other household members (see pages 8-10).
21. Social Security and/or Railroad Retirement.............................................................
21. __________________
22. Interest and/or Dividends .........................................................................................
22. __________________
23. Pensions and/or Annuities ........................................................................................
23. __________________
24. SSI/SSP, AB and/or ATD ........................................................................................
24. __________________
25. Rental Income (or Loss). Attach Federal Form 1040 and Schedules......................
25. __________________
26. Business Income (or Loss). Attach Federal Form 1040 and Schedules..................
26. __________________
27. Gain (or Loss). Attach Federal Form 1040 and Schedules .....................................
27. __________________
28. Other Income (Including Wages) (See page 9) .......................................................
28. __________________
29. Income of Other Household Members. Do not include income of minors,
students or renters. (See page 9)...............................................................................
29. __________________
30. SUBTOTAL. Add lines 21-29 ................................................................................
30. __________________
31. Adjustments to Income. Attach Federal Form 1040 and Schedules .......................
(See page 9-10).........................................................................................................
31. __________________
32. TOTAL Household Income. Subtract line 31 from line 30. If line 32 is more
than $35,500, STOP. You do not qualify for Property Tax Postponement. ...........
32. __________________
1
YES
NO
33. Is your residence part of a Cooperative Housing Corporation? (See page 10) ................
YES
NO
34. Is your residence based on a Leasehold (Possessory) Interest? (See page 10) ................
YES
NO
35. Is your residence based on a Life Estate or under a Contract of Sale? (See page 10) ......
YES
NO
36. Is your residence a floating home or mobile home that is situated on rented or leased
land? (See page 10) ..........................................................................................................
If yes, please enter your mobile home decal number. ___________
YES
NO
37. Is any portion of your property used for Rental or Business? (See page 10)....................
If yes, please enter the percentage devoted to your personal use. ___________%
PLEASE ATTACH ALL REQUIRED DOCUMENTATION TO THIS CLAIM FORM, INCLUDING A
COPY OF YOUR MOST RECENT PROPERTY TAX BILL.
PLEASE SIGN THE COMPLETED FORM. (See page 11)
Mail your completed claim form and all supporting documents to:
JOHN CHIANG, CALIFORNIA STATE CONTROLLER
PROPERTY TAX POSTPONEMENT PROGRAM
P.O. BOX 942850
SACRAMENTO, CALIFORNIA 94250-5880
Under penalty of perjury, I declare that this claim, including accompanying documents, is to the best of my
knowledge true, correct, and complete.
CLAIMANT’S SIGNATURE
DATE
SIGNATURE OF OTHER OWNER
DATE
SIGNATURE OF OTHER OWNER
DATE
Signatures of all property owners are required.
For Controller’s Use Only
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