Stanislaus County, CA · Stanislaus County
Welfare Exemption Supplemental Affidavit, Housing – Elderly or Handicapped Families
Nonprofit organizations and eligible limited liability companies use this affidavit to report qualifying elderly or handicapped family housing when seeking a welfare exemption.
At a glance
- Issued by
- City of Stanislaus County · Stanislaus County, Stanislaus County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- Original source unavailable. Use the archived PDF.
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This supplemental affidavit supports a welfare exemption claim for housing owned and operated by a nonprofit organization or eligible limited liability company. The instructions say to file a separate affidavit for each property location with the county assessor by February 15 to avoid a late filing penalty. It asks for applicant and property details, household income information, family counts, an exemption calculation, and a signed certification.
Who needs it
A nonprofit organization or eligible limited liability company seeking a welfare exemption for elderly or handicapped family housing files this affidavit for each property location.
How to submit it
File the affidavit with the County Assessor by February 15 at 1010 Tenth Street, Suite 2400, Modesto, CA 95354-0863. Do not submit the family income worksheets; keep completed, signed worksheets for possible audits.
About notarization
This document is signed and dated without a notary; the family income worksheets must be signed, but the instructions say to keep them rather than submit them.
How to submit this form
- 1
Download the Affidavit
Download the Welfare Exemption Supplemental Affidavit for elderly or handicapped family housing.
- 2
Complete the Form
Enter applicant and property details, household information, family counts, the exemption calculation, and the claimant’s certification.
- 3
Gather Family Worksheets
Provide each resident family with the income reporting worksheet and keep completed, signed worksheets for possible audits; do not submit them.
- 4
File With the County Assessor
File a separate affidavit for each location with the County Assessor by February 15.
Frequently asked questions
- Do I need a notary for the Welfare Exemption Supplemental Affidavit?
- No. The affidavit includes a certification signed by the claimant without a notary. Family income worksheets must be signed, but the instructions say to keep them and not submit them.
- How do I submit the Welfare Exemption Supplemental Affidavit?
- File it with the County Assessor by February 15 at 1010 Tenth Street, Suite 2400, Modesto, CA 95354-0863. Do not submit the family income worksheets; keep them for possible audits.
- Who files this housing exemption affidavit?
- A nonprofit organization or eligible limited liability company seeking a welfare exemption for elderly or handicapped family housing files a separate affidavit for each property location.
- What information does the affidavit request?
- It requests applicant and property identification, household income and family information, a recap of eligible and ineligible families, an exemption calculation, and the claimant’s certification.