MARK CHURCH
EF-263-R12-0617-41000433-1                                                                    Assessor - County Clerk - Recorder
BOE-263 (P1) REV. 1 2(0 -16 7)                                                                555 County Center
                                                                                              Redwood City, CA 94063
LESSORS’ EXEMPTION CLAIM                                                                      P 650.363.4500    F 650.599.7435
PROPERTY USED FOR FREE PUBLIC LIBRARIES AND                                                   email assessor@smcacre.org
FREE MUSEUMS, AND PROPERTY USED EXCLUSIVELY                                                   web www.smcacre.org
FOR PUBLIC SCHOOLS, COMMUNITY COLLEGES, STATE 
COLLEGES, STATE UNIVERSITIES, UNIVERSITY OF 
CALIFORNIA, CHURCHES, AND NONPROFIT COLLEGES
             NAME AND MAILING ADDRESS
             (Make necessary corrections to the printed name and mailing address)

                                                                                             This claim must be filed with the Assessor 
                                                                                             by February 15.
IDENTIFICATION OF APPLICANT
LESSOR’S CORPORATE OR ORGANIZATION NAME

MAILING ADDRESS

CITY, STATE, ZIP CODE

CORPORATE ID (IF ANY)

IDENTIFICATION OF PROPERTY 
ADDRESS OF PROPERTY (NUMBER AND STREET)                                                                                        FISCAL YEAR OF CLAIM
                                                                                                                               20___  – 20___
CITY, COUNTY, ZIP CODE                                                                                      ASSESSOR’S PARCEL NUMBER

USE OF PROPERTY               R Check and state the primary and incidental qualifying uses of the property.
The exemption claim is made for the following property:  (if there are numerous properties, please attach a list that clearly identifies the 
                                                       property and the name and address of the lessee)
                  PROPERTY TYPE                                                  PRIMARY USE                     INCIDENTAL USE
         Land
         Buildings and Improvements
         Personal Property
NAME OF QUALIFYING LESSEE INSTITUTION

MAILING ADDRESS                                                                               CITY, STATE, ZIP CODE

  Yes         No     The lease confers upon the lessee the exclusive right to possession and use of the property, except that for free public libraries 
                     and free museums, the statute does not require “exclusive” use.
  Yes         No     Property in this claim for exemption will be reported by the lessor on a business property statement submitted to the Assessor. 
                     (See instructions for property statement filing requirements.)
  Yes         No     An affidavit is attached in which the lessee declares it exclusively uses the property for exempt purposes. If No, the affidavit will 
                     be submitted by the lessor with the property statement.
                                                                                 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 PERSON MAKING CLAIM                                                                            DATE
t
NAME OF PERSON MAKING CLAIM                                                                                 TITLE

EMAIL ADDRESS                                                                                               DAYTIME TELEPHONE
                                                                                                            ( )
                                     THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION

EF-263-R12-0617-41000433-2
BOE-263 (P2) REV. 12 (06-17)

                            INSTRUCTIONS FOR FILING LESSORS’ EXEMPTION CLAIM

IMPORTANT NOTICE

A qualifying institution is one whose property is used for free public libraries and free museums, and for property used 
exclusively for public schools, community colleges, state colleges, state universities, University of California, churches, 
and nonprofit colleges.

Failure to submit the lessee’s affidavit will result in denial of the exemption for the lessor. Submission of the lessee’s affidavit 
after the date the claim form is due (for taxpayers not required to file a property statement) or after the last day for filing the 
lessor’s property statement without penalty under section 463 of the Revenue and Taxation Code (for taxpayers required to 
file a property statement) will result in a portion of the exemption being denied. A Lessee’s Affidavit is not required for free 
public library or free museum exemption.

A sample affidavit is included as page 3 of this form.

IDENTIFICATION OF APPLICANT
Enter your company or organization information.

FISCAL YEAR
The fiscal year for which an exemption is sought must be entered correctly. The proper fiscal year follows the lien date (12:01 
a.m., January 1) as of which the taxable or exempt status of the property is determined. For example, a person filing a timely
claim in February 201 7would enter “201 -2017 ”8on line five of the claim; a “2016-201 ”7entry on a claim filed in 
February 201 7would signify that a late claim was being filed for the preceding fiscal year. The lease must be in effect and 
the property in use on lien date of the fiscal year for which the exemption is sought. Lessors' Exemptions cannot be 
prorated based on the commencement date of the lease.

USES OF PROPERTY
Check each of the types of property being claimed, and state the primary and incidental uses of the property. 

Enter the name and address of the lessee. If additional space is required, or if more than one lessee is being listed, attach 
an itemized list.

Confirm, by checking the appropriate box, that the lease confers upon the lessee the exclusive right to possession and use 
of the property, except for free public libraries and free museums.

Check the appropriate box regarding property statement reporting. If you own taxable personal property in any county whose 
aggregate cost is $100,000 or more for any assessment year, you must file a property statement with the Assessor of that 
county whether or not specifically requested to do so. Any person not otherwise required to file a statement shall do so upon 
request of the Assessor, regardless of aggregate cost.

Check the appropriate box to indicate whether the affidavit is attached or will be submitted with the property statement.

If the property, or a portion thereof, for which exemption is claimed is a student bookstore that generates unrelated business 
taxable income as defined in section 512 of the Internal Revenue Code, property taxes are determined by establishing a 
ratio of the unrelated business taxable income to the bookstore’s gross income.

PROPERTY TAX BENEFITS
Property tax benefits claimed herein must be passed on to the lessee in the form of:
(1) Reduction in rental payments (sections 202.2 and 206.2, Revenue and Taxation Code).
(2) Refund of rental payments, if paid (sections 202.2 and 206.2, Revenue and Taxation Code).
(3) Claim by lessee under the provisions of section 5096, Revenue and Taxation Code, for a refund of taxes paid by a 
             lessor (section 202.2, Revenue and Taxation Code).
Note:  Where the lessee files a claim for an exemption and reports leased property, such property will be allowed the 
exemption if used in an exempt manner.

EF-263-R12-0617-41000433-3
BOE-263 (P3) REV. 12 (06-17)
RETURN THIS 
AFFIDAVIT TO 
LESSOR                      AFFIDAVIT FOR EXECUTION BY QUALIFYING INSTITUTIONAL LESSEES
NAME OF QUALIFYING LESSEE INSTITUTION

MAILING ADDRESS

CITY, STATE, ZIP CODE

R Check the type of qualifying exclusive use of the property
             PUBLIC SCHOOL                         STATE UNIVERSITY                                     NONPROFIT COLLEGE
             COMMUNITY COLLEGE                     UNIVERSITY OF CALIFORNIA
             STATE COLLEGE                         CHURCH
NAME OF LESSOR

MAILING ADDRESS

CITY, STATE, ZIP CODE

COMMENCEMENT DATE OF LEASE                                  DATE PROPERTY PUT TO EXEMPT USE

                                            PLEASE ATTACH A COPY OF THE LEASE AGREEMENT
The following property is leased as of January 1 of this year. If personal property is being leased, indicate the type, make, model, serial number, 
etc. Attach a separate listing if necessary.
 PROPERTY TYPE                                              PROPERTY DESCRIPTION
(REAL OR PERSONAL)

 Yes          No  The property described herein, or a portion thereof, is used by a church for parking purposes.
                  If Yes    , is the congregation of the church, religious denomination, or sect greater than 500 members?  Yes   No  
                  If Yes    , the property or portion thereof so used is not eligible for exemption.
 Yes          No  The property, or a portion thereof, is a student bookstore that generates unrelated business taxable income as defined in section 
                  512 of the Internal Revenue Code.
                  If Yes, a copy of the institution’s most recent tax return filed with the Internal Revenue Service must accompany this affidavit. 
                  Property taxes are determined by establishing a ratio of the unrelated business taxable income to the bookstore’s gross 
                  income.
                                                            CERTIFICATION
I understand that the lessor has filed for a property tax exemption on the above property leased to this institution, and that any benefit from the 
  exemption must go to this institution by way of a reduction in rental payments or a refund in an amount equal to the reduction in taxes.
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 PERSON MAKING CLAIM                                                                    DATE
t
NAME OF PERSON MAKING CLAIM                                                                         TITLE

EMAIL ADDRESS                                                                                       DAYTIME TELEPHONE
                                                                                                    ( )
                                 THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION