MARK CHURCH
EF-60-NR-R03-0208-41000836-1                                                                                            Assessor - County Clerk - Recorder
BOE-60-NR (FRONT) REV. 3 (2-08)                                                                                         555 County Center
                                                                                                                        Redwood City, CA 94063
NOTICE OF RESCISSION OF CLAIM                                                                                           P 650.363.4500    F 650.599.7435
TO TRANSFER BASE YEAR VALUE TO                                                                                          email assessor@smcacre.org
REPLACEMENT DWELLING                                                                                                    web www.smcacre.org

REPLACEMENT DWELLING
ASSESSOR’S PARCEL NUMBER                                RECORDER’S DOCUMENT NUMBER

DATE OF PURCHASE                     PURCHASE PRICE     DATE OF COMPLETION OF NEW CONSTRUCTION                                 COST OF NEW CONSTRUCTION 

                                     $                                                                                         $
PROPERTY ADDRESS (street, city, county, state, zip code)

DATE ORIGINAL CLAIM WAS FILED

CLAIMANT INFORMATION (please print)
NAME OF CLAIMANT                                                                                                               SOCIAL SECURITY NUMBER

NAME OF SPOUSE (provide if the spouse is a record owner of either the original property or the replacement dwelling)           SOCIAL SECURITY NUMBER

Please check the box under which you are fi ling this Notice of Rescission:

 (1) This Notice of Rescission must be fi led with the Assessor:

 • Before the date the county fi rst issues a refund check for the property taxes on the transferred base year value.
 • If a refund is not applicable, before any property taxes are paid on the new transferred base year value.
 • If taxes have not been paid, before any property taxes on the new transferred base year value become delinquent.

 OR

 (2) This Notice of Rescission must be fi led with the Assessor:

 • Within 6 years after relief was granted, and
 • The replacement property was vacated as the principal place of residence within 90 days after the original claim
 was fi led.

                                                        CERTIFICATION

 I/We certify (or declare) under penalty of perjury under the laws of the State of Californiathat                               the foregoing, and all 
                 information hereon, is true, correct, and complete to thebest                                       of my/our knowledge and belief.
CLAIMANT’S SIGNATURE                                                                                                           DATE

W
SPOUSE’S SIGNATURE                                                                                                             DATE

W
HOME PHONE NUMBER                                                                                                              DAYTIME PHONE NUMBER
(   )                                                                                                                          (   )
MAILING ADDRESS (including zip code)                                                                                           E-MAIL ADDRESS

                                                        All information provided on this form is subject to verifi cation.
                     IF YOUR APPLICATION IS INCOMPLETE, YOUR NOTICE OF RESCISSION MAY NOT BE PROCESSED. 
                                                        THIS NOTICE IS NOT SUBJECT TO PUBLIC INSPECTION

EF-60-NR-R03-0208-41000836-2
BOE-60-NR (BACK) REV. 3 (2-08)

                              GENERAL INFORMATION
                              (A fee may be required to process this document.)

California law allows any person who is at least 55 years of age (at the time of sale of original/former property) 
who resides in a property eligible for the homeowners’ exemption (place of residence) or currently receiving 
the disabled veterans’ exemption to transfer the base year value of the original property to a replacement 
dwelling of equal or lesser value. The replacement dwelling must be purchased or newly constructed within two 
years of the sale of the original property. A claim must be fi led with the Assessor within three years of the date 
the replacement dwelling is purchased or new construction of that replacement dwelling is completed.

A claimant may rescind their previously fi led claim for a base year value transfer. A claim may be rescinded 
according to Revenue and Taxation Code section 69.5(i) if this notice of rescission, signed by the original 
claimant(s), is delivered to the Assessor’s offi ce (where the claim was fi led) before any of the following have 
occurred:

• The county fi rst issues a refund check for the property taxes on the transferred base year value.

• If a refund is not applicable, before property taxes are paid on the new transferred base year value.

• If taxes have not been paid, before property taxes on the new transferred base year value become
delinquent.

Beginning January 1, 2001, a claimant may rescind their previously fi led claim for a base year value transfer 
if the replacement dwelling was vacated as the claimant’s principal place of residence within 90 days after the 
date the original claim for a base year value was fi led, and this notice of rescission is fi led with the Assessor 
within six years after the relief was granted. Within six years after the relief was granted means within six 
years from the date the county issues a refund check or property taxes are paid on the new transferred 
base year value.

If this rescission increases the base year value of a property, or the homeowners’ exemption has been 
incorrectly allowed, appropriate escape assessments or supplemental assessments, including interest 
as provided in section 506, shall be imposed. The statue of limitations for any escape or supplemental 
assessment will not commence until July 1 of the assessment year in which the notice of rescission is fi led 
with the Assessor.

If a claim is successfully rescinded, then the base year value from the original property may be transferred 
to another property as long as the second property also meets all the requirements of section 69.5: (1) The 
replacement dwelling (land and improvements) must have been acquired or newly constructed within two 
years of the sale of the original property; (2) the replacement dwelling is of equal or lesser value than the 
original property; (3) a claim for relief must be fi led within three years of the date the replacement dwelling 
is purchased or new construction of that replacement dwelling is completed.

PLEASE NOTE: Transfers between counties are allowed only if the county in which the replacement dwelling 
is located has passed an authorizing ordinance. The acquisition of the replacement dwelling must occur on 
or after the date specifi ed in the county ordinance.

                              (Please complete applicable information on reverse side.)