California Form 9000r - Renter Assistance Claim - 2003
Download a blank fillable California Form 9000r - Renter Assistance Claim - 2003 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete California Form 9000r - Renter Assistance Claim - 2003 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Reset Form
Print and Reset Form
YEAR
CALIFORNIA FORM
Renter
2003
9000R
Assistance Claim
(for income received in 2002)
Your first name
Last name
Initial
STEP A
Last name
Spouse’s first name
Initial
Name,
address,
Present home address — number and street, PO Box or rural route
Apt. no.
PMB no.
and
social
security
State
ZIP Code
City, town, or post office
-
number
Your social security number
Spouse’s social security number
IMPORTANT:
SSN
-
-
-
-
Your social security number
is required.
STEP B
•
1. Are you a United States citizen? Check “Yes” or “No” . .
1.
NO
YES
If you checked “Yes,’’ skip line 2 and go to line 3.
Filing
If you checked “No,’’ go to line 2.
•
Status
2. Benefit Eligibility for Noncitizens . . . . . . . . . . . . . . . . . . . .
2a.
Alien Status Code
I f you are not a citizen of the United States, go to page 15. If you
have a qualifying alien status for the United States, enter your
•
Alien Registration
alien status code from the chart on page 15 on line 2a. Then
2b.
Number
enter your alien registration number on line 2b and your date
•
of entry into the United States on line 2c.
2c.
Date of Entry
3. Check the appropriate box if you were one of the following on
December 31, 2002:
•
A. 62 years or older (see Note on page 7, line 3a) . . . .
A
•
B. Under 62 and blind . . . . . . . . . . . . . . . . . . . . . . . . . .
B
•
C. Under 62 and disabled (not blind) . . . . . . . . . . . . . .
C
•
4. Enter your date of birth (example: 0 5/ 2 1 / 1 9 3 8) . . . . .
4.
MM DD Y Y Y Y
Date of Birth
You must enter your date of birth
See instructions on page 7 and page 8 to see if you must attach a proof
document to your claim. If you cannot check one of the boxes, STOP
HERE. You do not qualify to file for a Renter Assistance claim.
STEP C
5. Enter the total number of months during 2002 that you
lived in a qualified rented residence in California.
•
________months
Rental
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
Information
6. If the address where you lived during 2002 is different than the address you
entered in Step A, or if the address in Step A is a post office box, enter your 2002
Complete
residence address. (If more than one rented residence attach a list.)
line 5
Street Address
City
through
line 7.
¼
_________________________________________________________________________________________
State and ZIP Code
¼
___________________________________________
/
/
/
/
________________
________________
RENTED FROM
TO
7. Enter the name, address, and telephone number of your landlord or the person
to whom you paid rent during 2002.
NAME ___________________________________________________________________________________________________________
ADDRESS ______________________________________________________________________________ APT. OR UNIT NO._________
_____________________
CITY _______________________________________________________ STATE and ZIP CODE_________
TELEPHONE (
) ____________________________________
For Privacy Act Notice, see Page 14.
FTB 9000R 2003 Side 1
Complete Side 2, Step D Through Step H.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal