MARK CHURCH
EF-267-S-R11-0512-41000808-1                                                                     Assessor - County Clerk - Recorder
BOE-267-S (P1) REV. 11 (05-12)                                                                   555 County Center
                                                                                                 Redwood City, CA 94063
RELIGIOUS EXEMPTION                                                                              P 650.363.4500    F 650.599.7435
                                                                                                 email assessor@smcacre.org
This claim is filed for fiscal year 20 ____ - 20 ____.                                           web www.smcacre.org
(Example: a person filing a timely claim in January 2011 would 
enter "2011-2012.")

         NAME AND MAILING ADDRESS 
         (Make necessary corrections to the printed name and mailing address.)
                                                                                                    FOR ASSESSOR’S USE ONLY

                                                                                     Received by           (Assessor’s designee)

                                                                                     of   (county or city)  on                 (date)

IDENTIFICATION OF APPLICANT
CORPORATE OR ORGANIZATION NAME OF CHURCH

dba LOCAL CHURCH NAME

MAILING ADDRESS

CITY, STATE, ZIP CODE

CORPORATE ID (IF ANY)                     WEBSITE ADDRESS (IF ANY) 

IDENTIFICATION OF PROPERTY 
ADDRESS OF PROPERTY (NUMBER AND STREET)

CITY, COUNTY, ZIP CODE                                                                              ASSESSOR’S PARCEL NUMBER

1.Is this real property owned by the church?    Yes       No  
(a)   If Yes, enter the date the property was acquired:                       Enter date first used for church/school purposes:
(b)   If No, provide the name and address of the owner:
    Note: If the owner is not another church, a Church or Welfare Exemption Claim form must be filed. Contact the Assessor.
2.Please check the following, if applicable:
(a)      The property is owned by an entity organized and operating exclusively for religious purposes.
(b)      The entity is a nonprofit organization
(c)      No part of the net earnings inures to the benefit of any private individual.
USE OF PROPERTY
3. Are all buildings, equipment, and land claimed used exclusively for religious purposes?
 Yes         No   If No, explain:  

4.Is there any portion of the property currently under construction?
(a)       Yes     No   If Yes, is that property intended to be used solely for religious purposes?   Yes    No  
(b)   Date(s) of construction:  
(c)   Please describe new construction activity:  

5.Has any new construction been completed on this property since January 1, 12:01 a.m. last year?
 Yes         No   If Yes, provide the date of completion:
(a)   Date the new construction was put to exempt use:  
(b)   Describe the use of this property:  
                                   THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION

EF-267-S-R11-0512-41000808-2
BOE-267-S (P2) REV. 11 (05-12)

6. Does the real property include property used for parking purposes?
      Yes   No  
 If Yes, is all real property owned by or leased to the church, upon which exemption is claimed for parking purposes, necessarily and reasonably 
 required for parking of automobiles of persons attending or engaged in religious worship or religious activity, and which is not at other times
 used for commercial purposes?      Yes   No
 Note: Commercial purposes does not include the parking of vehicles or bicycles, the revenue of which does not exceed the ordinary and
 necessary costs of operating and maintaining the property for parking purposes.
7. Is there a sanctuary (church) on or adjacent to this property?
      Yes   No  
 If No, a claim for Welfare Exemption must be filed with the Assessor by February 15 each year for the property or portion of the property.
8. Check, as applicable, the type(s) of schools being operated on this property.
     Preschool                           Kindergarten                           Secondary school
     Nursery school                      Elementary school                      Both secondary and college
9. Are bingo games being operated on this property?
      Yes   No  
 If Yes  , a claim for Welfare Exemption must be filed with the Assessor by February 15 each year for the property or portion of the property.
10. Is any equipment or other property at this location being leased or rented from someone else?
      Yes   No  
 If Yes  , list in the remarks section the name and address of the owner, and the type, make, model, and serial number of the property.
 Note: Leased personal property is eligible for the Religious Exemption if the personal property is used exclusively for religious purposes.
11.Is any portion of this property used for living quarters for any person?
      Yes   No    If Yes, describe:

 Note: Living quarters are not eligible for either the Religious Exemption or the Church Exemption. The property may be eligible for the Welfare 
 Exemption - contact the Assessor.
12.Is any portion of this property vacant and/or unused?
      Yes   No  If Yes, describe:

13.Is any portion of this property being rented to, leased to, used and/or operated by a person or organization other than the claimant?
      Yes   No  
 If Yes  , describe that portion, its use, and provide the name and address of the lessee/operator:

14.Has there been any change in the use of this property since 12:01 a.m., January 1 of last year?
      Yes   No  If Yes, describe:

15.Remarks.

                              Whom should we contact during normal business hours for additional information?
NAME                                                                                               TITLE

DAYTIME TELEPHONE                  EMAIL ADDRESS
(       )
                                                        CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information contained herein, 
         including any accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief.
NAME OF PERSON MAKING CLAIM                                                                        TITLE

SIGNATURE OF PERSON MAKING CLAIM                                                                   DATE
t

EF-267-S-R11-0512-41000808-3
BOE-267-S (P3) REV. 11 (05-12)

         INSTRUCTIONS FOR FILING A CLAIM FOR RELIGIOUS EXEMPTION FROM PROPERTY TAX

This affidavit is required under the provisions of sections 206.1, 207, 207.1, 214.4, 251, 255, 257, 257.1, 260, 270, and 271 
of the Revenue and Taxation Code.

GENERAL INFORMATION
The Religious Exemption may be claimed on property owned by a religious organization and used exclusively for religious 
purposes. This includes religious worship and school purposes, including preschools, nursery schools, kindergartens, schools 
of less than collegiate grade, or schools of collegiate grade and less than collegiate grade. The exemption is also available 
if another church uses the property part time for religious worship and operates a school, provided that the owner church 
continues to conduct worship services on the property. Property used for school purposes only, where there are no church 
services, does not qualify for the Religious Exemption but may qualify for the Welfare Exemption. 

The law provides for one-time filing for the Religious Exemption by the claimant and the annual mailing of a termination notice 
by the Assessor.  Penalties for failure to terminate the exemption when no longer eligible are also a part of the law.

FILING OF AFFIDAVIT
To receive the full exemption, this form must be filed with the Assessor by February 15.  (Section 270 provides a partial 
exemption for late filing of the Religious Exemption.)  Once granted, the exemption remains in effect until terminated. 

IDENTIFICATION OF APPLICANT
Identify the corporate or organization name of the church seeking exemption on the property.  Include the mailing address, 
website address (if any), and corporate identification number (if any).

IDENTIFICATION OF PROPERTY
Identify the location of the property for which you are seeking exemption.  A separate claim form must be filed for each 
location.

USE OF PROPERTY
Please answer all questions in this section of the claim form.  

Please note that there are three exemptions that may be claimed on church property: the Church Exemption, the Religious 
Exemption, and the Welfare Exemption.  If it does not appear that your organization qualifies under the Religious Exemption, 
please contact the Assessor.  

The Church Exemption may be claimed on property that is owned, leased, or rented by a religious organization and used 
exclusively for religious worship services. The Church Exemption is the most restrictive of the three exemptions available 
to a church since the organization’s property must be used solely for religious worship and other activities reasonably 
necessary for the accomplishment of the church’s religious purposes.  The welfare exemption may be claimed on property 
that is used for other than religious worship and schools, such as housing for clergy, bingo, a convent or a retreat, summer 
camp, or if the church property is used regularly by a charitable organization.