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MARK CHURCH
EF-266-R12-0514-41000898-1 Assessor - County Clerk - Recorder
BOE-266 (P1) REV. 1 2(05-1 )4 555 County Center
Redwood City, CA 94063
CLAIM FOR HOMEOWNERS’ PROPERTY TAX EXEMPTION P 650.363.4500 F 650.599.7435
If eligible, sign and file this form with the Assessor on or before February 15 or on or email assessor@smcacre.org
before the 30th day following the date of notice of supplemental assessment, web www.smcacre.org
whichever comes first.
SEE INSTRUCTIONS BEFORE COMPLETING
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address)
FOR ASSESSOR’S USE ONLY
Received
Approved
Denied
Reason for denial
PROPERTY DESCRIPTION
Parcel No.
Address of dwelling
Print your social security number and name here SSN: - -
u
NAME:
Print co-owner’s or spouse’s social security number and name when
this property is also his/her principal residence SSN: - -
u
NAME:
STATEMENTS
This claim may be used to file for the Homeowners’ Exemption for the Assessment Roll and the Supplemental Assessment Roll.
A new owner must file a claim even if the property is already receiving the homeowners’ exemption. Please carefully read the
information and instructions before answering the questions listed below.
1. When did you acquire this property?
(month/day/year)
2. Date you occupied this property as your principal residence (see instructions):
(month/day/year)
3. Do you own another property that is, or was, your principal place of residence in California? YES NO
If YES, please provide the address below, and the date you moved out, if no longer your principal place of residence:
Address: Street address City Zip Code month/day/year
Only the owners or their spouses who occupy the above-described property (including a purchaser under contract of sale) or his or
her legal representative may sign this claim. (If the property comprises more than one dwelling unit, other co-owner occupants may
wish to file separate claims; however, only one exemption will be allowed per dwelling unit.)
If you are buying this property under an unrecorded contract of sale and the Assessor does not have a copy of the contract,
you must attach a copy to this claim.
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon,
including any accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief.
SIGNATURE OF OWNER-OCCUPANT DATE
t
SIGNATURE OF OCCUPANT’S SPOUSE OR CO-OWNER-OCCUPANT DATE
t
EMAIL ADDRESS DAYTIME TELEPHONE NUMBER
( )
IF YOU DO NOT OCCUPY THIS PARCEL AS YOUR PRINCIPAL RESIDENCE, PLEASE DISCARD THIS FORM.
If you occupy this parcel at a later date, contact the Assessor at that time.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
