Form Boe-261-G (P1) - Claim For Disabled Veterans' Property Tax Exemption - State Of California - 2013 Page 4
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5BOE-261-G (P4) REV. 21 (05-12)
LOCATION OF THE DWELLING. If the parcel number or the legal description of the property and the address of the dwelling are printed on
the form, check to see that they are printed correctly and correct them if they are not. These entries identify the dwelling on which you claim the
exemption.
If the dwelling has no street address, so state. Do not enter a post office box number for the address of the dwelling.
INSTRUCTIONS FOR STATEMENTS
Item 1. Please answer the applicable questions. The Assessor will allow the proper exemption(s).
Item 2. Please answer the applicable questions.
Item 3. A veteran must check one of the boxes (a), (b), or (c). An unmarried surviving spouse must check either box (d) or box (e); if box (d)
is checked, the surviving spouse must also check the box indicating the disability of the deceased veteran. Proof of disability must be
attached to the claim. If original documents are forwarded to the Assessor, the Assessor will make a copy and return the originals to you.
The unmarried surviving spouse must include both a marriage license and proof of the deceased veteran’s disability.
Item 4. If you are claiming the Low-Income Exemption, compute your household income as determined below and enter the net household income
(total of A less total of B) on item 4 of the claim.
Household Income (section 20504)
Household income means all income received by all persons of a household while members of such household. Include only the income of persons
who were members of the household during the calendar year prior to the year of this claim (if the claim is for 2012, the income would be for the
calendar year 2011.)
The term household includes the claimant and all other persons, except bona fide renters, minors, or students.
A. Household income includes:
(You will not be required to attach a list showing your income, but such a list should be retained by you for audit purposes.)
(1)
Wages, salaries, tips, and other employee compensation.
(2)
Social Security, including the amount deducted for Medi-Care premiums.
(3)
Railroad retirement.
(4)
Interest and dividends.
(5)
Pensions, annuities and disability retirement payments.
(6)
SSI/SSP (Supplemental Security Income/State Supplemental Plan), AB (Aid to the Blind), ATD (Aid to Totally Disabled), AFDC
(Aid to Families with Dependent Children), and APSB (Aid to the Potentially Self-Supporting Blind).
(7)
Rental income (or loss).
(8)
Net income (or loss) from a business.
(9)
Income (or loss) from the sale of capital assets.
(10)
Life insurance proceeds that exceed expenses.
(11)
Veterans benefits received from the Veterans Administration.
(12)
Gifts and inheritances in excess of $300, except between members of the household.
(13)
Unemployment insurance benefits.
(14)
Workers compensation for temporary disability (not for permanent disability).
(15)
Amounts contributed on behalf of the claimant to a tax sheltered or deferred compensation plan (also a deduction), see (c) below.
(16)
Sick leave payments.
(17)
Nontaxable gain from the sale of a residence.
(18)
Income received by all other household members while they lived in the claimant’s home during the last calendar year except
a minor, student, or renter.
B. Adjustments to Income
Section 17072 of the Revenue and Taxation Code provides for an adjusted gross income, which means, in the case of an individual,
gross income minus the following deductions:
(a) Forfeited interest penalty.
(b) Alimony paid.
(c) Individual retirement arrangement, Keogh (HR 10), Simplified Employee Plan (SEP), or SIMPLE plans.
(d) Employee business expenses.
(e) Moving expenses and deductions of expenses (already taken) for the production of income (or loss) reported in Items 7 (rental), 8
(business), and 9 (sale of capital assets) included in income.
(f) Student loan interest.
(g) Medical savings account.
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