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Printable Form 433-A Santa Clarita California: What You Should Know

This form is filled out by a resident. In order to get the information you need on the form, you must be a resident of the State or Country of the information on part I or Part II. The address on Part I or Part II is your mailing address. The address on part 3 is for our records only. You must be physically located with the City office. For information as to how we store and maintain the information of the resident on the form, please see the page entitled City of Santa Clarita, CA: How We Store, Edit and Delete Your Personal Information. The form must be used (i.e. printed and turned in) by the Resident Signatures: Full Name, Address, City First analyst Name, City, County, State, Zip, Country Last 4 of SSN Signature of Resident Address, City, County, State, Zip, Country Signature (if not present, type on a separate sheet of paper) First and Last Name, City, County, State, Zip, Country Last Name, City, County, State, Zip, Country Signature of Resident Signature of Resident Full Name, First and Last Name, City, County, State, ZIP, Country In addition to providing your name and address, you must sign on the bottom, “Under penalty of perjury,” the following statement: Signature of Resident Signature of Resident Full Name, First and Last Name, City, County, State, Zip, Country To complete Part II, a signature is required: Signature of Resident Full Name, First and Last Name, City, County, State, ZIP, Country If you are required to report income from multiple sources (such as rental incomes, business investment income, etc.), you must complete the form twice, once for the current tax year and once for any prior tax year.

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