Los Altos School District Parcel Tax Exemption Program
Mt. Pleasant School District
3434 Marten Ave, San Jose, CA 95148 (408) 223-3763
2018-2019
ANNUAL REQUEST FOR EXEMPTION FROM THE PARCEL TAX
OWNER / OCCUPANTS AGE 65 AS OF MAY 31
FISCAL YEAR_____________________________________
ASSESSOR’S PARCEL NUMBER (APN #)
NAME
ADDRESS
TELEPHONE NUMBER
BIRTHDATE
Signature of Applicant or Designee
Signature of Co-Applicant
Date of Request
OFFICE USE ONLY
RESIDENCE VERIFICATION BIRTHDATE VERIFICATION
Driver’s License/California ID Card Driver’s License/California ID Card
Utility Bill Birth Certificate
Social Security Check Passport
Tax Bill Medicare Card
VERIFIED BY:
Mt. Pleasant School District
DATE:
Senior Exemption:
Any owners of a Parcel used solely for owner-occupied, single-family residential purposes and who are (a) 65 years of age or older or (b) persons receiving Supplementary Security Income for a disability, regardless of age, may obtain an exemption from the education parcel tax for that fiscal year by annually submitting an application, by July 1st of any year.
Original - District Office Copy – Applicant Parcel Tax
Account #010-0960-0-8621 June 8, 2010
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