Form Ppb-8 - Property Tax Assistance Application - 2011 Page 3
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5Application for Non-Filers of 2010 Income Tax
If you are not required to fi le a tax return, use this form to calculate your total household income.
Report the 2010 combined total household income of all owners who occupied the property as their primary
residence during the preceding calendar year. Do not subtract losses, depletion, or depreciation.
Wages, salaries, tips, etc.
.................................................................................................$
,
.
Taxable interest
................................................................................................................$
,
.
Ordinary and qualifi ed dividends
......................................................................................$
,
.
Alimony received
..............................................................................................................$
,
.
Capital gains (report losses as 0)
.....................................................................................$
,
.
Other gains (report losses as 0)
.......................................................................................$
,
.
Taxable refunds, credits or offsets of state and local income taxes
.................................$
,
.
Business and/or farm income before subtracting losses, depreciation and/or depletion
.$
,
.
Taxable amount of IRA distributions, pensions and annuities
..........................................$
,
.
Rental, royalties, partnerships, S corporations, trust income before subtracting losses,
depreciation and/or depletion
...........................................................................................$
,
.
Unemployment compensation
..........................................................................................$
,
.
Taxable amount of social security benefi ts (do not include social security paid directly
to a nursing home or social security for dependent children.)
..........................................$
,
.
Other income
....................................................................................................................$
,
.
Total household income
................................................................................................$
,
.
If you need additional information in order to estimate your income, please call the Montana Department of
Revenue help desk toll free at 1-866-859-2254 (in Helena 444-6900) or visit our website at revenue.mt.gov.
*11QQ0301*
*11QQ0301*
PPB-8
Rev. 01 11
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