MARK CHURCH
EF-236-R06-0512-41000844-1                                                                Assessor - County Clerk - Recorder
BOE-236 REV. 06 (05-12)
                                                                                          555 County Center
                                                                                          Redwood City, CA 94063
EXEMPTION OF LEASED PROPERTY USED                                                         P 650.363.4500    F 650.599.7435
EXCLUSIVELY FOR LOW-INCOME HOUSING                                                        email assessor@smcacre.org
                                                                                          web www.smcacre.org
This claim is filed for fiscal year 20 ____ - 20 ____.
(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)

NAME OF ORGANIZATION

MAILING ADDRESS (number and street)                                                       CITY, STATE, ZIP CODE

ADDRESS OF PROPERTY FOR WHICH THE EXEMPTION IS CLAIMED (number and street, city)                                ASSESSOR’S PARCEL NUMBER

1. Was the property leased to the lessee for a term of 35 years or more, or was the lease transferred to the lessee with a remaining term of 35 years or
more? (The Assessor may require a copy of the lease be submitted.)
 YES                   NO

2. Was the property used exclusively and solely for rental housing and related facilities for tenants who are persons of low income as defined in section
50093 of the Health and Safety Code?
 YES                   NO
An affidavit affirming that the tenants’ incomes do not exceed the limits provided by section 50093 of the Health and Safety Code:
  is attached             will be provided within       days              will be provided by the lessee (if this claim is filed by the lessor).
The exemption cannot be allowed without the income affidavit.

3. The property is leased and operated by a (check one):
 a. Religious, hospital, scientific, or charitable fund, foundation, or corporation. Note: if this box is checked, the lessee must file and qualify for the
      Welfare Exemption provided by section 214 of the Revenue and Taxation Code in order for this exemption claim to be allowed.
 b. Public housing authority or public agency.
 c. Limited partnership in which the managing general partner has received a determination that it is a charitable organization under section 501(c)
      (3) of the Internal Revenue Code. If this box is checked, copies of the determination letter, the limited partnership agreement, and the Certificate
      of Limited Partnership (LP-1), including any amendments (LP-2), showing endorsement by the Secretary of State
          are attached      will be submitted by the lessee. The exemption cannot be allowed without these documents.

                         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 hereon, including any 
                       accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief.
SIGNATURE OF PERSON MAKING CLAIM                                                                           TITLE
t
NAME OF PERSON MAKING CLAIM                                                                                DATE

                                    THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION