Form Boe-267 - Instructions For Claim For Welfare Exemption (First Filing) (Page 2 of 2) in pdf

BOE-267 (P4) REV. 14 (10-16)

COMPLETION OF CLAIM FORM

All questions must be answered. Failure to answer all questions and provide requested information may result in denial of your claim.

Use “not applicable” where needed. The following information is provided to assist you in answering specific questions on your claim.

The fiscal year for which exemption is being 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 2017 would enter “2017-2018”; a “2016-2017” entry on a claim filed in February 2017 would signify that a late claim was being

filed for the preceding fiscal year.

Section 1. IDENTIFICATION OF PROPERTY

Identify the situs location (address and city) and Assessor’s Parcel/Assessment Number of the property owned for which you are

seeking exemption; when the property was put to exempt use; and check the appropriate box(es) to indicate type(s) of property.

Claimant is responsible for completing sections 2 through 4 depending on which box(es) are checked under section 1(d). Refer to P3

for the definition of real property and taxable possessory interest. Personal property is defined as all property except real property, such

as office furniture, computers, and equipment.

Section 2. REAL PROPERTY Complete only if “Real Property” was checked under Section 1(d).

(a)

If the exemption is being claimed for real property, enter the date on which the property was acquired.

(b)

Indicate the area and the unit of measurement used (acres or square feet).

(c)

List all buildings and improvements on the land, using additional sheets if necessary.

(d)

Describe the primary use which should qualify the property for exemption and the incidental use(s) of the property since

January 1 of the prior year.

(e)

If Yes, submit BOE-267-O, to provide information on every user of your real property.

Section 3. PERSONAL PROPERTY Complete only if “Personal Property” was checked under section 1(d).

Describe the type of personal property, and the primary use and incidental use(s) of the property since January 1 of the prior year. If

yes to (c) or (d), then provide requested information.

Section 4. TAXABLE POSSESSORY INTEREST Complete only if “Taxable Possessory Interest” was checked under section 1(d).

Attach a copy of the current lease agreement, identify the public owner (local, state, or federal agency) of the publically owned land,

buildings and/or improvements, and describe the type of property that is leased from the public owner.

Section 5. USE OF PROPERTY

(a)(1)

If Yes, describe in sufficient detail to determine the volume of business and the hours open for business since January 1 of

the prior year. If a business operation located on the listed parcel has been deliberately omitted because you do not desire

the exemption on the business, so state.

(a)(2)

If Yes, submit BOE-267-R.

(b)

If Yes, describe the portion of the property used for living quarters. Submit documentation, including tenets, canons, or written

policy, that indicates the organization requires housing be provided to employees and/or volunteers. Include a statement as to

why such housing is incidental to and reasonably necessary for the exempt purpose of the organization and the occupant’s

role or position in the organization. (This question is not applicable where the exempt activity is providing housing, for

example, homes for aged, youth, or mentally or physically disabled.) If living quarters are associated with a rehabilitation

program, submit BOE-267-R.

(c)

If Yes, submit BOE-267-L if owned by a nonprofit organization or limited liability company; submit BOE-267-L1 if owned by a

limited partnership.

(d)

If Yes, submit BOE-267-H, unless care or services are provided or the property is financed by the federal government under,

including but not limited to, sections 202, 231, 236, or 811 of the Federal Public Laws. Submit documentation on the type of

financing or care/services.

Section 6. UNRELATED BUSINESS TAXABLE INCOME

If Yes, provide the documents and other information requested.

Section 7. EXPANSION

If Yes, describe the type of investment contemplated and the reasons that make such expansion necessary.

Section 8. FINANCIAL STATEMENTS

Submit the financial statements reflecting the operation of the subject property. The income and expenses should include only those

that result from operation of the property. If compensation of personnel or other administrative expenses are pro-rated to the property,

such pro-rata should be indicated. If the nature of an item of income or expense is not clear from the account name, further explanation

indicating the nature of the account should be appended. Your claim will not be processed until the financial statements are

received by the Assessor.

Section 9. OTHER – EXEMPT ACTIVITY AND USE

Check the appropriate boxes to indicate the requested information.

Form Boe-267 - Instructions For Claim For Welfare Exemption (First Filing) Page 2

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