MARK CHURCH
EF-261-D-R02-0810-41000428-1                                                                 Assessor - County Clerk - Recorder
BOE-261-D (P1) REV. 02 (08-10)                                                               555 County Center
                                                                                             Redwood City, CA 94063
SERVICEMEMBERS CIVIL RELIEF ACT                                                              P 650.363.4500    F 650.599.7435
DECLARATION                                                                                  email assessor@smcacre.org
                                                                                             web www.smcacre.org
Pursuant to section 571( ) ofdthe Servicemembers Civil 
Relief Act (50 U.S.C. Appendix), the personal property of a 
servicemember shall not be deemed to be located or present in, 
or to have a situs for taxation in, the tax jurisdiction in which the 
servicemember is serving in compliance with military orders.

SERVICEMEMBER NAME                                                                               DAYTIME TELEPHONE NUMBER
                                                                                                 (        )
RANK                           ORGANIZATION                 SOCIAL SECURITY OR SERIAL NUMBER     E-MAIL ADDRESS

MAILING ADDRESS                                                       CITY                                     STATE ZIP CODE

LEGAL RESIDENCE ADDRESS                                               CITY                                     STATE ZIP CODE

VOTER REGISTRATION CITY                                               COUNTY                                   STATE YEAR LAST VOTED

         LIST BELOW ANY PERSONAL PROPERTY OR MANUFACTURED HOME LOCATED IN CALIFORNIA.

                                                 PERSONAL PROPERTY
            PROPERTY TYPE                              DESCRIPTION                                   SERIAL/ID NUMBER

                                                 MANUFACTURED HOME
                MANUFACTURER                     YEAR OF MANUFACTURE                             DECAL/SERIAL NUMBER

INSTRUCTIONS:
1. List personal property by type, description, and serial number or ID number.
2. Enter the manufacturer, year of manufacture, and decal or serial number of a manufactured home.
3. Attach a copy of your current leave and earnings statement.
4. Sign and date the declaration. If you are signing this document with Power of Attorney, attach a copy of the document
   through which you have been granted the Power of Attorney.
5. Mail the original declaration with attachments to the Assessor’s office at the address shown.

                                                       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 and correct to the best of my knowledge and belief.
SIGNATURE OF DECLARANT                                                                           DATE
t
                               THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION