Property Tax Postponement Claim - California State Controller - 2000 Page 2
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2On line 17 through line 24, enter your INCOME for the 1999 calendar year. If you are married, include your spouse’s income.
On line 25, enter the total income of other household members. (See pages 12 – 14.)
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17. Social Security and/or Railroad Retirement …………………………………….….
17.
_______________
•
18. Interest and/or Dividends ………………………………………………………………
18.
_______________
•
19. Pensions and/or Annuities …………………………………………………………….
19.
_______________
•
20. SSI/SSP……………………………………………………………….
20.
_______________
•
21. Rental Income (or Loss). Attach Federal Form 1040 and Schedules …………….
21.
_______________
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22. Business Income (or Loss). Attach Federal Form 1040 and Schedules ………...
22.
_______________
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23. Capital Gain (or Loss). Attach Federal Form 1040 and Schedules …………….…
23.
_______________
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24. Other Income (including Wages) (See page 13.) ……………………………...….
24.
_______________
25. Income of Other Household Members. Do not include income of minors,
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25.
_______________
students or renters. (See page 14.) ……………………………………………………
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26. SUBTOTAL. Add lines 17 through 25 …………………………………………………
26.
_______________
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27. Adjustments to Income. Attach documentation. (See page 14.) …………………
27.
_______________
28. TOTAL HOUSEHOLD INCOME. Subtract line 27 from line 26 …………………….
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28.
_______________
If line 28 is more than $24,000, (or $34,000 if you qualified in 1983) STOP. You do
not qualify.
29. IS YOUR RESIDENCE A PART OF A COOPERATIVE HOUSING CORPORATION?
(See page 15.)
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 policy of title insurance.
YES
NO
(See pages 15-16.)
31. IS YOUR RESIDENCE BASED UPON A LIFE ESTATE OR UNDER A CONTRACT OF SALE?
If yes, attach written consent from remainderman or the title holder. (See page 16.)
YES
NO
32. IS YOUR RESIDENCE A MOBILEHOME OR FLOATING HOME THAT IS SITUATED ON OR
NEAR RENTED OR LEASED LAND? If yes, attach a copy of your current Certificate of Title
YES
NO
and/or Registration Card. (See pages 16-17.)
33. IS ANY PORTION OF YOUR PROPERTY USED FOR RENTAL OR BUSINESS? If yes, enter
the percentage devoted to your personal use. (See pages 17-18.) _________________%
YES
NO
The percentage indicated is the amount that is eligible for postponement.
PLEASE SIGN THE COMPLETED FORM. ATTACH ALL REQUIRED DOCUMENTS AND MAIL TO:
KATHLEEN CONNELL, CALIFORNIA STATE CONTROLLER
DIVISION OF COLLECTIONS
PROPERTY TAX POSTPONEMENT PROGRAM
P.O. BOX 942850
SACRAMENTO, CALIFORNIA 94250-5880
AN INCOMPLETE APPLICATION AND/OR MISSING DOCUMENTS WILL RESULT IN A DELAY IN PROCESSING.
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
SIGNATURE OF OTHER OWNER
Signatures of all property owners are required. (See page 18.)
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