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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