Form HCD475.9 "Disabled Veteran Application for Exemption From the in Lieu Tax Fee for Manufactured Home or Mobilehome" - California

What Is Form HCD475.9?

This is a legal form that was released by the California Department of Housing & Community Development - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2014;
  • The latest edition provided by the California Department of Housing & Community Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form HCD475.9 by clicking the link below or browse more documents and templates provided by the California Department of Housing & Community Development.

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Download Form HCD475.9 "Disabled Veteran Application for Exemption From the in Lieu Tax Fee for Manufactured Home or Mobilehome" - California

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STATE OF CALIFORNIA
BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM
DISABLED VETERAN
APPLICATION FOR EXEMPTION FROM THE IN LIEU TAX FEE
FOR MANUFACTURED HOME OR MOBILEHOME
SECTION I.
DESCRIPTION OF UNIT
The Decal (License) Number(s):
The Trade Name is:
The Serial No.(s) is:
SECTION II.
REGISTERED OWNER INFORMATION
Name:
Address:
Street Address or P.O. Box
City
State
Zip
SECTION III.
REQUEST FOR $20,000 EXEMPTION
I/We, the undersigned, hereby state that the manufactured home/mobilehome described above is my/our principal place of residence and request the
exemption of the first $20,000 of the market value of the manufactured home/mobilehome identified on this form due to the following:
Disabled Veteran was disabled as a result of injury or disease incurred in military service.
(CHECK ONE)
Veteran was resident of California at the time of entry into the service, who is blind, or lost the use of two or more limbs, or is totally disabled; OR
Veteran was resident of California on November 7, 1972, and blind in both eyes, or lost the use of two or more limbs; OR
Veteran was resident of California on January 1, 1975, and was totally disabled.
Spouse Complete the following:
(CHECK ONE)
I am the spouse of a Disabled Veteran who was disabled as a result of injury or disease incurred in military service as indicated above; OR
I am the unmarried surviving spouse of a Disabled Veteran who was disabled as a result of injury or disease incurred in military service as indicated
above.
DEFINITIONS
1. "Blind in both eyes" means having a visual acuity of 5/200 or less.
2. "Lost the use of a limb" means that the limb has been amputated or its use has been lost by reason of ankylosis, progressive muscular dystrophies,
or paralysis.
3. "Totally disabled" means that the United States Veterans Administration or the military service from which such veteran was discharged has rated
the disability of 100 percent or have rated the disability compensation at 100 percent by reason of being unable to secure or follow a substantially
gainful occupation.
4. All units of the manufactured home/mobilehome must be combined before the exemption can be granted.
SECTION IV.
REQUEST FOR $30,000 EXEMPTION
Dependent on your income, you may be eligible for an additional $10,000 exemption. If you believe you may be eligible, complete the following
information:
My/Our total household income for the last calendar year of
was $
.
SECTION V.
OWNERSHIP STATUS
VETERAN OR SPOUSE COMPLETE THE FOLLOWING TO INDICATE OWNERSHIP OF THE MANUFACTURED HOME OR MOBILEHOME
Veteran Only
100% Exemption
Veteran and Two Other People (other than spouse) 34%Exemption
Veteran and Spouse
100% Exemption
Spouse and Two Other People
34% Exemption
Spouse Only
100% Exemption
Veteran and Spouse and Two Other People
50% Exemption
Veteran and Another Person (other than spouse)
50% Exemption
Veteran and Three Other People
25% Exemption
Spouse and Another Person (other than veteran)
50% Exemption
Spouse and Three Other People
25% Exemption
Veteran and Spouse and Another Person
67% Exemption
OTHER (Type of ownership is not shown).
Indicate type of ownership:
SECTION VI.
CERTIFICATION
Executed on
at
Date
City
State
I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature(s):
Address:
Street Address or P.O. Box
City
State
Zip
HCD 475.9 (Rev. 12/14)
STATE OF CALIFORNIA
BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM
DISABLED VETERAN
APPLICATION FOR EXEMPTION FROM THE IN LIEU TAX FEE
FOR MANUFACTURED HOME OR MOBILEHOME
SECTION I.
DESCRIPTION OF UNIT
The Decal (License) Number(s):
The Trade Name is:
The Serial No.(s) is:
SECTION II.
REGISTERED OWNER INFORMATION
Name:
Address:
Street Address or P.O. Box
City
State
Zip
SECTION III.
REQUEST FOR $20,000 EXEMPTION
I/We, the undersigned, hereby state that the manufactured home/mobilehome described above is my/our principal place of residence and request the
exemption of the first $20,000 of the market value of the manufactured home/mobilehome identified on this form due to the following:
Disabled Veteran was disabled as a result of injury or disease incurred in military service.
(CHECK ONE)
Veteran was resident of California at the time of entry into the service, who is blind, or lost the use of two or more limbs, or is totally disabled; OR
Veteran was resident of California on November 7, 1972, and blind in both eyes, or lost the use of two or more limbs; OR
Veteran was resident of California on January 1, 1975, and was totally disabled.
Spouse Complete the following:
(CHECK ONE)
I am the spouse of a Disabled Veteran who was disabled as a result of injury or disease incurred in military service as indicated above; OR
I am the unmarried surviving spouse of a Disabled Veteran who was disabled as a result of injury or disease incurred in military service as indicated
above.
DEFINITIONS
1. "Blind in both eyes" means having a visual acuity of 5/200 or less.
2. "Lost the use of a limb" means that the limb has been amputated or its use has been lost by reason of ankylosis, progressive muscular dystrophies,
or paralysis.
3. "Totally disabled" means that the United States Veterans Administration or the military service from which such veteran was discharged has rated
the disability of 100 percent or have rated the disability compensation at 100 percent by reason of being unable to secure or follow a substantially
gainful occupation.
4. All units of the manufactured home/mobilehome must be combined before the exemption can be granted.
SECTION IV.
REQUEST FOR $30,000 EXEMPTION
Dependent on your income, you may be eligible for an additional $10,000 exemption. If you believe you may be eligible, complete the following
information:
My/Our total household income for the last calendar year of
was $
.
SECTION V.
OWNERSHIP STATUS
VETERAN OR SPOUSE COMPLETE THE FOLLOWING TO INDICATE OWNERSHIP OF THE MANUFACTURED HOME OR MOBILEHOME
Veteran Only
100% Exemption
Veteran and Two Other People (other than spouse) 34%Exemption
Veteran and Spouse
100% Exemption
Spouse and Two Other People
34% Exemption
Spouse Only
100% Exemption
Veteran and Spouse and Two Other People
50% Exemption
Veteran and Another Person (other than spouse)
50% Exemption
Veteran and Three Other People
25% Exemption
Spouse and Another Person (other than veteran)
50% Exemption
Spouse and Three Other People
25% Exemption
Veteran and Spouse and Another Person
67% Exemption
OTHER (Type of ownership is not shown).
Indicate type of ownership:
SECTION VI.
CERTIFICATION
Executed on
at
Date
City
State
I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature(s):
Address:
Street Address or P.O. Box
City
State
Zip
HCD 475.9 (Rev. 12/14)