3504: Enrolled Tribal Member Certification (2025)
California · FTB · Used for tax years 2025
California Form 3504, Enrolled Tribal Member Certification, records your tribal enrollment, reservation residency, and income qualifying as exempt. It includes residency verification by an authorized tribal government representative and information about any residential property
What you'll need
Have the following information ready for your 2025 Form 3504:
- Your name, SSN, mailing address, and physical address.
- Your tribe’s name and your tribal enrollment number.
- The reservation or reservations where you lived during the tax year and your dates of residency.
- Residency verification from an authorized tribal government representative who is on file with the Franchise Tax Board.
- For each exempt income source: the employer or source name, the physical address where you worked if applicable, the income type, and the amount qualifying as exempt.
- Details about any residential property you own outside the boundaries of California Indian country, including its address, use, occupants, and dates you lived there, if applicable.
If you reside on a reservation of a tribe different from the one in which you are enrolled, attach a copy of your tribal enrollment card.
Common mistakes
- Do not use a PO box as your physical address.
- Do not omit the copy of your tribal enrollment card if you reside on a reservation of a tribe different from your enrolled tribe.
- Make sure the person verifying your residency is authorized by the Tribal Chairperson and/or Tribal Council and is on file with the Franchise Tax Board.
- Complete Part IV if you own residential property outside the boundaries of California Indian country.
- Before signing, check that the form and everything included with it are true, correct, and complete. The certification is made under penalty of perjury.
Questions people ask
Who can verify my reservation residency?
A designated person within the tribal government must verify it. That person must have authority from the Tribal Chairperson and/or Tribal Council and must be on file with the Franchise Tax Board. The person declares your residency based on personal knowledge and provides their name, title, signature, and date.
When do I need to attach my tribal enrollment card?
Attach a copy if you reside on a reservation of a tribe different from the one in which you are enrolled.
What income information does Part III request?
It asks for the employer’s name or source of exempt income, the physical address where you worked if applicable, the income type, and the amount qualifying as exempt. The form directs you to the General Information section of the instructions for exemption requirements.
Do I need to report residential property outside California Indian country?
Yes, if you own residential property outside those boundaries. Part IV asks for each property’s physical address, use, who lived there, and the dates you lived there, if applicable.