Form Boe-267-L - Welfare Exemption Supplemental Affidavit, Housing - Lower Income Households Page 3
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3BOE-267-L (P3) REV. 13 (01-12)
INSTRUCTIONS FOR FILING
WELFARE EXEMPTION SUPPLEMENTAL AFFIDAVIT
HOUSING — LOWER INCOME HOUSEHOLDS
FILING OF AFFIDAVIT
This affidavit is required under the provisions of sections 214(g), 214.15, 251, and 254.5 of the Revenue and Taxation Code
and must be filed when seeking exemption on low-income housing property owned and operated by a nonprofit corporation
or eligible limited liability company. A separate affidavit must be filed for each location and the income of the occupants
must not exceed certain limits (see section 4 of the claim form). This affidavit supplements the claim for welfare exemption
and must be filed with the county assessor by February 15 to avoid a late filing penalty under section 270. If you do not
complete and file this form, you may be denied the exemption. The claimant should provide each household living on the
property with a copy of form BOE-267-L-A, Lower Income Households - Family Household Income Reporting Worksheet.
The organization claiming the exemption keeps the completed, signed statements in case of further audit. Do not
submit the worksheets with your filing.
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 2011 would enter “2011-2012” on line four of the claim; a “2010-2011” entry on a claim filed in February
2011 would signify that a late claim was being filed for the preceding fiscal year.
SECTION 1. Identification of Applicant.
Identify the name of the organization seeking exemption on the low-income housing property, corporate identification number
or LLC number, and mailing address.
SECTION 2. Identification of Property
Identify the location of the low-income housing property, county in which the property is located, and the date the property
was acquired by the organization.
SECTION 3. Government Financing or Tax Credits; Use Restriction.
Check all applicable boxes to certify if: (1) the property use is restricted to low-income housing by a recorded regulatory
agreement or recorded deed restriction or other legal document, and (2) the funds that would have been necessary to pay
property taxes are used to maintain the affordability of the housing or to reduce the rents for the units occupied by lower
income households, and (3) the property receives either federal low-income housing tax credits or government financing
or 90 percent or more of the occupants of the property are lower income households whose rent does not exceed the rent
prescribed by section 50053 of the Health and Safety Code.
SECTION 4. Household Information.
Include a list of households that qualify for exemption based on the maximum income level for the county for the claim year
where the property is located (see dollar amount on table). Also, please indicate which vacant units are held for low-income
housing tenants.
OBTAINING CLAIM FORMS FROM THE STATE BOARD OF EQUALIZATION
Claim form BOE-277, Claim for Organizational Clearance Certificate - Welfare Exemption, is available on the Board’s website
( ) or you may request the form by contacting the Exemptions Section at 916-274-3430.
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