Property Tax Postponement Claim Form - 2006
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2006
PROPERTY TAX POSTPONEMENT CLAIM
A
06-07
1. SOCIAL SECURITY NUMBER
2. FIRST NAME
MID. INITIAL
LAST NAME
For
Controller’s
3. YOUR DATE OF BIRTH
Use Only
19_ _
day
Year
PLEASE PLACE PREADDRESSED LABEL HERE, IF AVAILABLE
month
4. IN CARE OF NAME (IF APPLICABLE)
APN
5. MAILING ADDRESS
(NUMBER AND STREET)
County Code
6. (CITY)
(COUNTY)
(STATE)
(ZIP CODE)
Letter Code
7. SOCIAL SECURITY NUMBER OF SPOUSE
DATE OF BIRTH OF SPOUSE OR
NAME OF SPOUSE OR REGISTERED
OR REGISTERED DOMESTIC PARTNER
REGISTERED DOMESTIC PARTNER
DOMESTIC PARTNER
19_ _
Percent No.
day
year
month
8. ADDRESS OF RESIDENTIAL DWELLING)
(NUMBER AND STREET)
9. (CITY)
(COUNTY)
(STATE)
(ZIP CODE)
Timely Code
ELIGIBILITY FILING REQUIREMENTS:
Multi Parcel
10. If you will be 62 or older on December 31, 2006, check this box.
62 or older
11. If you are under 62 on December 31, 2006, and are BLIND
Income
Blind
OR DISABLED, check the appropriate box.
Proof of disability is required each year.
Disabled
12. Do you have delinquent taxes?
YES
NO
UNSURE
If you checked the “NO” or “UNSURE” box, skip to #13.
Enter the year your taxes become delinquent:
________________
Were you at least 62 or disabled at the time your taxes became delinquent?
YES
NO
13. Enter the year you purchased your home:
________________
14. Enter, to the best of your knowledge, the total amount of liens, deeds of trust, mortgages
or other encumbrances recorded against your home: (See page 12.)
$________________
15. Is your property held in a trust? If yes, attach a copy of your entire Trust
Agreement if a copy has not already been provided. (See Page 10.)
YES
NO
16. As of December 31, 2005, have you and all other recorded owners, except spouse, registered domestic
partner, and direct-line relatives, owned and occupied the property for which taxes are to be postponed?
(See pages 1 and 13)
YES
NO
TRANSFER
List name(s) and relationship(s) of all owners of your property. Anyone listed below whom IS NOT a
spouse, registered domestic partner, or direct-line relative must also submit proof of eligibility.
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH
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