Form Ppb-8 - Application For Property Tax Assistance Program - 2009
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1MONTANA
Clear Form
PPB-8
Rev. 03-09
Application for Property Tax Assistance Program
15-6-134, MCA
______________________________ County
This form, including all supporting documentation, must be returned to your local DOR Office or postmarked by April 15 or
we cannot allow a reduction. Any reduction you qualify for is applicable to the first $100,000 or less of the taxable market
value of the qualifying property. You will receive a follow up letter indicating whether your application has been approved
or denied.
- For Office Use Only -
Name: _____________________________________________
Geocode:
Mailing Address: _____________________________________
School District:
City, State Zip: _______________________________________
Assessment Code:
Legal Description of Property: _________________________________________________________________________
_________________________________________________________________________________________________
I / we own or are under contract for deed to purchase a:
q
q
home (please check one) that may include land up to 5 acres.
mobile/manufactured home, or
I / we occupied that same residence for at least 7 months last year as our primary residence.
q
My tax filing status is:
Single (not more than $19,944).
My federal adjusted gross income as reported on last year’s federal income tax return* is $ ___________
A copy of my 2008 federal income tax form is attached.
q
My / our tax filing status is:
Married (not more than $26,592) or
q
Head of Household** (not more than $26,592).
My / our combined federal adjusted gross income as reported on last year’s federal income tax return* is $ ____________
A copy (or copies, if filed separately) of my / our 2008 federal income tax form is attached.
If you are not required to file a federal income tax return you need to determine and provide evidence of what your
*
federal adjusted gross income would have been had you been required to file.
** If claiming head of household, you must complete the information at the bottom of this form.
Under penalty of law, I affirm that the information provided in this form is true and correct.
Signature __________________________________________
Social Security Number ________________________
Name of Spouse _____________________________________
Social Security Number ________________________
Phone ________________________________
Date ______________________________
Head of Household Information
q
q
For Office Use Only –
Approved
Disapproved
(to be completed by the applicant)
Income
Class Codes
Name of Dependent
SSN
Married or Head of
Single
Household
%
Land
Imp
Mob
$
0 - $ 7,978 $
0 - $ 10,637
20
2132
3137
6237
$ 7,979 - $ 12,232 $ 10,638 - $ 18,614
50
2135
3140
6240
$ 12,233 - $ 19,944 $ 18,615 - $ 26,592
70
2137
3142
6242
459
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