Form Boe-682 - Homeowner And Renter - Property Tax Assistance Appeal Form - California

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BOE-682 (S1F) REV. 1 (1-05)
STATE OF CALIFORNIA
HOMEOWNER AND RENTER
BOARD OF EQUALIZATION
PROPERTY TAX ASSISTANCE APPEAL FORM
YOUR NAME (please print or type)
MAILING ADDRESS
CITY
STATE
ZIP CODE
DAYTIME PHONE
SOCIAL SECURITY NO.
CASE ID NO. (if already issued)
(
)
Type of assistance you applied for (check one)
Homeowner
Renter
CLAIM AMOUNT
CLAIM YEAR
DATE OF BIRTH
Please explain why you think the FTB was wrong when it denied your claim and why you think you are
eligible for assistance. Please be as specific as possible. If you need more room, use the back of this form
(please print or type). Attach photocopies of any documents that support your explanation.
If you want someone to represent you, list that person’s name, address, and telephone number below.
NAME OF REPRESENTATIVE
MAILING ADDRESS
CITY
STATE
ZIP CODE
DAYTIME PHONE
(
)
If you have provided information for a representative, have that person sign and date below. If you do not
have a representative, you must sign and date.
SIGNATURE
DATE
Please photocopy your completed form for your records. Mail the original to the address shown on the
back of this form. Attach a copy of each document that supports your appeal and a copy of the FTB
denial notice or letter. Please do not send original documents with your appeal.

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