MARK CHURCH
EF-FC02-R02-0614-41000421-1                                Assessor - County Clerk - Recorder
CAA-FC02-REV.02(06-14 )                                    555 County Center, 3rd Floor
                                                           Redwood City, CA 94063
                                                           P 650.363.4771    F 650.599.7435
                                                           email assessor@smcacre.org
                                                           web www.smcacre.org

HOMEOWNERS’ EXEMPTION TERMINATION NOTICE 
You must notify the Assessor whenever a property you own is no longer eligible 
for a Homeowners’ Exemption. To avoid potential penalties, this must be done by 
                        th
December 10  of the year in which the change occurs. 
You are entitled to a Homeowners’ Exemption on one property in California.                         A property
is eligible for a Homeowners’ Exemption if you own and occupy it as your primary residence
                        st
on January 1 . A property is not eligible for an exemption if it is rented, unoccupied, or 
used as a vacation or secondary home. Failure to notify the Assessor may result in escape
assessments and/or penalties and interest for the exempted taxes. 

I do not qualify for the Homeowners’ Exemption on the property located at: 

Assessor Parcel Number: (Please Print) 

______________________________________________________________________ 

Property Address: 

______________________________________________________________________ 

Property Owner: 

______________________________________________________________________ 
Last Name                         First Name                      Middle

Please check the appropriate box below: 

                      I/we do not occupy the property as a principal residence as of (date):  _______________ 
                      This property is a rental, vacation or secondary home as of (date):  _________________ 
                      This property is vacant or unoccupied as of (date): ______________________________ 
                      I/we no longer own the property as of (date):  __________________________________ 
                      The property owner is deceased. The date of death is (date):  _____________________ 
                      I/we have an exemption on another property in California (address):  
                       ______________________________________________________________________ 
                      Other reason and date of change: 
                       ______________________________________________________________________ 
                       ______________________________________________________________________ 

Current Mailing Address:                                   This is my new primary residence. 

______________________________________________________________________ 
Street Address 

_______________________________________________   (____)________________ 
City                        State                      Zip        Daytime Phone Number

______________________________________________ ________________________
Signature      Date                                                                          Email