MARK CHURCH
EF-265-NT-R15-0519-41000495-1                                                                        Assessor - County Clerk - Recorder
BOE-265-NT (P1) REV. 1 5(05-1 )9                                                                     555 County Center
CEMETERY EXEMPTION                                                                                   Redwood City, CA 94063
                                                                                                     P 650.363.4500    F 650.599.7435
CHANGE IN ELIGIBILITY                                                                                email assessor@smcacre.org
OR TERMINATION NOTICE                                                                                web www.smcacre.org

        CLAIMANT NAME AND MAILING ADDRESS
        (Make necessary corrections to the printed name and mailing address)

                                                                                                         APN(s)

                                                                                                         LOCATION OF PROPERTY (if other than mailing address)

Dear Claimant:

Your organization was allowed the Cemetery Exemption for 201  on all9            or a portion of its property. The Cemetery Exemption 
is   available only to property which is owned by a nonprofit corporation and                 used exclusively for the burial or other permanent 
deposit of the human dead and property used or held exclusively for the care, maintenance or upkeep of such property or such dead. 
Under a  one-time filing rule or requirement, the Cemetery Exemption will remain in effect until all or a part of the property is used for 
activities that are outside the scope of the Cemetery Exemption.

If,  as  of  January  1,  2020,  you  still  own  the  property  and  the  activities  conducted  on  the  property            have  not  changed 
since  January 1, 2019, answer the question on the card “                   yes” and sign and return the card to the Assessor. The Assessor will 
continue the  exemption. If you do not return the card, it may result in an on-site inspection to verify that the property continues to be 
used for exempt  activities.

If, as of January 1, 2020, you no longer own the property or activities other than cemetery activities are taking place on the  
property, answer the question on the card “no” and sign and return the card to the Assessor within 30 days, so that the exemption can be  
modified or terminated. If you do not notify the Assessor when the property is no longer eligible for the exemption, it will result in an  
escape assessment plus interest and may result in a penalty of up to $250.

The following circumstances are those that may disqualify all or part of the property for the exemption:

     a.  No longer owned by a nonprofit corporation or an organization referred to in section 8250 of the Health and Safety Code.
     b.  The land is not actively used or held for exempt purposes.
     c.  Plots sold to brokers for purposes of resale.
     d.  Passively held land in excess of anticipated need.
     e.  Improvements that are not used for the burial or other permanent deposit of the human dead, or used or held exclusively for
         the care, maintenance or upkeep of such property (for example, floral shops, mortuaries, crematoriums, orchard or cropland).

EF-265-NT-R15-0519-41000495-2
BOE-265-NT (P2) REV. 15(0  5-1 )9

BOE-265-NT REV. 1 5(05-19)                               APN(s)
CEMETERY EXEMPTION
CHANGE IN ELIGIBILITY                                    LOCATION OF PROPERTY (if other than mailing address)
OR TERMINATION NOTICE (CARD)
(Section 256.6 of the Revenue and Taxation Code)
Failure to return this card does not constitute a waiver To all persons and entities that have received a nonprofit 
of this exemption as specified by the California         cemetery exemption for the 201 9-2020 fiscal year.
Constitution, but may result in an on-site inspection by QUESTION: Will the property to which the exemption applied in 
                                                         the 2019-20 20 fiscal year continue to be used exclusively for 
the Assessor to verify any exempt activity.              the burial or other permanent deposit of the human dead or for 
                                                         the care, maintenance, or upkeep of that property or those 
                                                         dead in the 2020-202 1fiscal year?
NAME AND MAILING ADDRESS
                                                            Yes           No
                                                         SIGNATURE 
                                                         u 
                                                         TITLE

                                                         TELEPHONE NUMBER
                                                         (      )