Property Tax Postponement Claim Form - 2006 Page 2
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1
2On lines 17-24, enter your income for the 2005 calendar year. If applicable, include the income of your spouse or registered domestic
partner. On line 25, enter the total income of other household members. (See pages 13-15.)
17. Social Security and/or Railroad Retirement.…………………………………………………. ….
17. _______________
18. Interest and/or Dividends.……………………………………………………………….…………
18.
_______________
19. Pensions and/or Annuities.……………………………………………………………..………….
19.
_______________
20. SSI/SSP, AB, and/or ATD………………………………………………………..………………...
20. _______________
21. Rental Income (or Loss). Attach Federal Form 1040 and Schedules.…………….………….
21.
_______________
22.
_______________
22. Business Income (or Loss). Attach Federal Form 1040 and Schedules.………………..…...
23. Capital Gain (or Loss). Attach Federal Form 1040 and Schedules.…………………….…. …
23.
_______________
24. Other Income (Including Wages) (See page 14.). ……………………………….…….. ……….
24.
_______________
25. Income of Other Household Members. Do not include income of minors, students or
25.
_______________
renters. (See page 15.). ……………………………………………………………………..………
26.
_______________
26. SUBTOTAL. Add lines 17-25.…………………………………………………….……………..…
27. Adjustments to Income. Attach documentation. (See page 15.).……………………..……..
27.
_______________
28. TOTAL household income. Subtract line 27 from line 26. If line 28 is more than
$24,000 (or $34,000 if you qualified in 1983), STOP. You do not qualify for property tax
28.
_______________
postponement.
29.
Is your residence part of a Cooperative Housing Corporation?
(See pages 3 and 16.)
YES
NO
30.
Is your residence based on a Leasehold (Possessory) Interest? If yes, first-time filers must attach a copy of the
recorded lease agreement and the policy of title insurance.
YES
NO
(See pages 3 and 16.)
31.
Is your residence based on a Life Estate or is it under a Contract of Sale? If yes, attach written consent from the
Remainderman or Titleholder.
(See pages 3 and 16.)
YES
NO
32.
Is your residence a Mobilehome or Floating home that is situated on Rented or Leased land? If yes, attach a
copy of your current certificate of title and/or registration card.
(See pages 3 and 17.)
YES
NO
33.
Is any portion of your property used for Rental or Business? If yes, enter the percentage devoted to your
personal use. ________________%
YES
NO
The percentage indicated is the amount that is eligible for postponement.
PLEASE SIGN THE COMPLETED FORM. (See page 17.) ATTACH ALL REQUIRED DOCUMENTS AND MAIL TO:
STEVE WESTLY, CALIFORNIA STATE CONTROLLER
DIVISION OF COLLECTIONS
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
(
)
TELEPHONE NUMBER
E-MAIL ADDRESS
SIGNATURE OF OTHER OWNER
Signatures of all property owners are required.
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