MARK CHURCH
EF-270-AH-R05-0810-41000394-1                                               Assessor - County Clerk - Recorder
BOE-270-AH REV. 05 (08-10)                                                  555 County Center
                                                                            Redwood City, CA 94063
EXHIBITION EXEMPTION CLAIM                                                  P 650.363.4500    F 650.599.7435
FROM PROPERTY TAXES                                                         email assessor@smcacre.org
                                                                            web www.smcacre.org
To receive the full exemption, a claimant 
must complete and file this form with the 
Assessor by February 15.

NAME OF EXHIBITOR

ADDRESS (STREET, CITY, STATE, ZIP CODE)

ADDRESS OF EXHIBITION (STREET, BOOTH, ETC.; BE SPECIFIC)

                                       LIST ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS CLAIMED
   DESCRIPTION             DATE ENTERED CALIFORNIA      DATE TAXES PAID AMOUNT OF TAXES PAID    STATE OR COUNTRY IN 
                                                                                                    WHICH PAID
1.

2.

3.

4.

5.
I hereby state that:
   (a)  The property is brought into this state exclusively for purposes of use or exhibition at an exposition, fair, carnival, or public 
        exhibit of literary, scientific, educational, religious, or artistic works in this state and is used only for these purposes while in this 
        state;
   (b)  I intend to remove the property from the state following its use or exhibition here;
   (c)  The property is subject to taxation in some other state or a foreign country while in this state, and all current taxes due in the 
        other state or country have been paid.

                                                                        Whom should we contact during normal 
                                                                        business hours for additional information?
                                                        NAME
                 FOR ASSESSOR’S USE ONLY
                                                        ADDRESS (STREET, CITY, STATE, ZIP CODE)
Received by
                           (Assessor’s designee)
of
                           (county or city)             DAYTIME PHONE NUMBER
on                                                      (         )
                                       (date)           E-MAIL 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                                   DATE
t
                                       THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION