A. The claim for deferral shall be on a form that is prescribed by the state treasurer and that provides an explanation of the requirements of this article and instructions for completing and filing the claim. The claim shall:

1. 1. Identify the residence by street address and tax parcel number.
2. 2. Recite the facts establishing the individual's and residence's eligibility for deferral, including all mortgages, reverse mortgages, deeds of trust and other security interests that constitute current liens on the residence with the year or years they were recorded.
3. 3. State the maximum amount of taxes that can be deferred on the residence. The cumulative amount of deferred taxes and interest that attaches to a tax deferred residence under this article, plus any amounts secured by mortgages, reverse mortgages, deeds of trust and other real property security interest with respect to the residence, may not exceed ninety per cent of the full cash value of the residence determined by the county assessor for the tax year.
4. 4. State the total taxable income of all persons residing in the residence for the taxable year immediately preceding the current year. The taxpayer shall attach a copy of the state income tax return filed by each person who resided in the residence during the preceding taxable year. If any person residing in the residence was not required to file a state income tax return under title 43 for the preceding taxable year, the taxpayer shall certify that the total taxable income of all persons residing in the residence for the taxable year immediately preceding the current year does not exceed ten thousand dollars.