Form Boe-263 - Lessor'S Exemption Claim (Page 2 of 2) in pdf

INSTRUCTIONS

The person signing this claim should enter his or her name on the first line.

Line 3.

If land and/or building, enter the street address and parcel number. If personal property, describe in sufficient detail to identify (e.g., type, make, model,

serial number, etc.). List the primary use to be made of the property; list other known uses of the property.

Line 4.

Enter the name and address of the lessee. If there is more than one lessee, you may attach an itemized list.

Line 7.

Check the appropriate box. 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.

Line 8.

If the lessee is a public school, community college, state college, state university, University of California, church or nonprofit college, you must submit

evidence of the lessee’s exclusive use of the property for exempt purposes. Submit in accordance with the box checked on the form an affidavit of the

lessee declaring under penalty of perjury that the property is exclusively used for the purpose for which is conferred. In the case of free public library or

free museum, exclusive use is not required, and the fact of the lessee’s possession is sufficient evidence of use.

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 as determined by establishing a ratio of the unrelated business taxable income to

the bookstore’s gross income will be levied.

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 mentioned in the heading of this form and reports leased property, such property will be allowed the

exemption if used in an exempt manner.

SAMPLE AFFIDAVIT FORM FOR EXECUTION BY INSTITUTIONAL LESSEES

State of California

County of ___________________________________________ Return to __________________________________________

(owner-lessor)

________________________________________________________________________________________ hereby declares:

(name of declarant)

1. That he or she is the ________________________________ of _______________________________________________

(title or office)

(name of lessee institution)

2. That this institution is a _______________________________________________________________________________

(type of institution, e.g., nonprofit private college)

qualifying for property tax exemption and meets all requirements prescribed by law for exemption.

3. That this institution leases from _______________________________________________________________ the following

(name of lessor)

_____________________________________________ property as of January 1 of this year. (Describe personal property— type, make,

(real or personal)

model, serial number, etc.)

a. ____________________________________________________________________________________________________________

b. ____________________________________________________________________________________________________________

c. ____________________________________________________________________________________________________________

That this leased property is being used/used exclusively for _____________________________________________________ purposes.

Date the lease was signed ____________________________________________________________________________________

Commencement date of the lease ______________________________________________________________________________

[The assessor may request a copy of the lease agreement(s)].

Is the property, or portion thereof, described herein used by a church for parking purposes? Yes

If yes, is the

congregation of the church, religious denomination, or sect greater than 500 members? Yes

If yes, the property,

or portion thereof, so used is not eligible for exemption.

Is the property, or a portion thereof, for which exemption is claimed a student bookstore that generates unrelated business taxable

income as defined in section 512 of the Internal Revenue Code? Yes

If yes, a copy of the institution’s most recent tax

return filed with the Internal Revenue Service must accompany this claim. Property taxes as determined by establishing a ratio of the

unrelated business taxable income to the bookstore’s gross income will be levied.

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 Declarant

Title

Date

BOE-263 (BACK) REV. 7 (8-07)

Form Boe-263 - Lessor'S Exemption Claim Page 2

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