MARK CHURCH
EF-68-R05-0807-41000826-1                                                                         Assessor - County Clerk - Recorder
BOE-68 (FRONT) REV. 5 (8-07)                                                                      555 County Center
                                                                                                  Redwood City, CA 94063
CLAIMCLAIMFOR BASE YEAR VALUE TRANSFER -FOR BASE YEAR VALUE TRANSFERP 650.363.4500    F 650.599.7435
ACQUISITIONACQUISITIONBY PUBLIC ENTITYBY PUBLIC ENTITY                                            email assessor@smcacre.org
(Article XIII A section 2(d), California Constitution;                                            web www.smcacre.org
section 68, Revenue and Taxation Code; Property Tax Rule 462.500)

A. REPLACEMENT PROPERTY
COUNTY IN WHICH LOCATED                                                    ASSESSOR’S PARCEL NUMBER

DATE OF PURCHASE                      PURCHASE PRICE                       CONSTRUCTION COST (if applicable)     COMPLETION DATE
                                      $                                    $
PROPERTY ADDRESS (street number, street name, city, state, zip code)

DEED VESTING (names of owners exactly as they appeared on deed)

USE OF PROPERTY (residence, apartment building, store, factory, farm, etc.)

B. TAKEN PROPERTY
ASSESSOR’S PARCEL NUMBER                                                   COUNTY IN WHICH LOCATED

PROPERTY ADDRESS (street number, street name, city, state, zip code)

DEED VESTING (names of owners exactly as they appeared on deed)

DATE YOU ORIGINALLY ACQUIRED PROPERTY                                      PRICE YOU ORIGINALLY PAID FOR PROPERTY
                                                                           $
USE OF PROPERTY (residence, apartment building, store, factory, farm, etc.)

NAME OF PUBLIC AGENCY ACQUIRING PROPERTY

DATE OF DISPLACEMENT                                                       PURCHASE PRICE PAID (excluding relocation benefits)
                                                                           $
C. DOCUMENTATION
Please submit:
(1)  A copy of the last tax bill you received on the taken property.
(2)  Documentation from acquiring public agency verifying the price paid and relocation cost paid, if any.
A
 •
 •
 •
 •
 •
  and the date of possession by the acquiring agency
                                                                           CERTIFICATION
                      I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and
                             all information hereon, is true, correct, and complete to the best of my knowledge and belief.
SIGNATURE OF CLAIMANT                                                                                        DATE
t
HOME PHONE NUMBER                                                                                            DAYTIME PHONE NUMBER

MAILING ADDRESS

                                                                           ASSESSOR’S USE ONLY
NAME OF COUNTY CONTACT PERSON                                                                                TELEPHONE NUMBER

                                                               BOARD OF EQUALIZATION’S USE ONLY
                      A prior inquiry has not been received on this property.
                      A prior inquiry has been received on this property. See attached form(s) for particulars.
REVIEWED BY                                                                                                  DATE

                                         All information provided on this form is subject to verification.
                              IF YOUR APPLICATION IS INCOMPLETE, YOUR CLAIM MAY NOT BE PROCESSED.

EF-68-R05-0807-41000826-2
BOE-68 (BACK) REV. 5 (8-07)
                                           GENERAL INFORMATION
         a 
comparable replacement property if that original property has been taken by eminent domain proceedings, acquisition by a public     entity, 
or governmental action resulting in a judgment of inverse condemnation.
To be considered comparable, a replacement property acquired by a person displaced under one of the three con ditions above            must 
be similar in size, utility, and function to the taken property. Replacement property is similar in size if its full cash value 
                                                                                                                  utility and function 
if it is, or is intended to be, used in the same manner as the property taken. Property is similar in utility and function if the property 
taken and the replacement property fall into the same category: Category A - single family and duplex;            Category B - commercial, 
investment, income, or vacant property; Category C - agricultural property. If replacement property is 
                                                                                     subject to reappraisal.
propert

       •                    not exceed                                                                  then
         the adjusted base year value of the taken property becomes the replacement property’s base year value.
       • Ifthefullcashvalueofthereplacementproperty exceeds  the 120 percent level, the amount of full cash value
         inexcessof120percentwillbeaddedtothebaseyearvalueofthetakenproperty         .Thissum becomesthe base year 
         value of the replacement property.
       • Iis                                        less than the base year value of the property taken, that

       •                                                                                                          determine
         the full cash value of both the property taken and the replacement property.
                                                                       Owner                                                    the 
real property taken.
ears

       •                                                                                                          property,

       •
       • Thedatethejudgmentofinversecondemnatiobecomesfinaorthedatethetaxpayervacatesthe                          replaced

       •
       •
       • T   datt“Notice    ofDetermination,”“Notic ofExemption,”orsimilarnotice,as requir              bytCalifornia
         Environmental  Quality Act (CEQA),  is recorded by the public entity  acquiring the taxpayer’s property                and the
         public project has been approved.
       •
Anyconstructrequirtmaktreplacementpropertycompartttakpropertyforthisproperty

       •
       •
       •
YoumustprovidetheAssessoracertifiedcopyofthefinalorderofcondemnationororderforpossession;acertifiedcopyofthe

                                                                                                                  the date of possession by 
the acquiring agency       .
TAfinformatrelatt fproperttreliefundertttofEqualizat