MARK CHURCH
EF-263-B-R02-0810-41000411-1                                                           Assessor - County Clerk - Recorder
BOE-263-B (P1) REV. 02 (08-10)                                                         555 County Center, 3rd Floor
LESSEES’ EXEMPTION CLAIM                                                               Redwood City, CA 94063
Declaration of property information as of 12:01 a.m.,                                  P 650.363.4501    F 650.599.7456
January 1, 20__.                                                                       email ppdutyauditor@smcacre.org
                                                                                       web www.smcacre.org
PROPERTY USED EXCLUSIVELY FOR PUBLIC 
SCHOOLS, COMMUNITY COLLEGES, STATE 
COLLEGES, STATE UNIVERSITIES, OR 
UNIVERSITY OF CALIFORNIA 
      NAME AND MAILING ADDRESS
      (Make necessary corrections to the printed name and mailing address)

                                                                                       To receive the full exemption, this claim must 
                                                                                       be filed with the Assessor by February 15.
IDENTIFICATION OF APPLICANT
LESSEE’S CORPORATE OR ORGANIZATION NAME

MAILING ADDRESS

CITY, STATE, ZIP CODE

CORPORATE ID (IF ANY)

IDENTIFICATION OF PROPERTY 
ADDRESS OF PROPERTY (NUMBER AND STREET)

CITY, COUNTY, ZIP CODE                                                                                    ASSESSOR’S PARCEL NUMBER

USE OF PROPERTY                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

 Yes   No        Does the lease/agreement confer upon the lessee the exclusive right to possession and use of the property?

 Yes   No        Is the claimant a lessee or operator of real or personal property owned by a public school, community college, state college, 
                 state university, or University of California that is used exclusively for community college, state college, state university, or 
                 University of California purposes?

Note: If requested by the assessor, the claimant shall provide a copy of the lease or agreement. 

                                                                          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

E-MAIL ADDRESS                                                                                            DAYTIME TELEPHONE
                                                                                                          (      )
                                 THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION