Form Boe-517-Ext - Request For Extension Of Time To File Property Statement
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1BOE-517-EXT REV. 10 (2-11)
STATE OF CALIFORNIA
REQUEST FOR EXTENSION OF TIME
BOARD OF EQUALIZATION
TO FILE PROPERTY STATEMENT
ASSESSEE’S NAME
SBE NO.
LIEN DATE (year)
ASSESSEE’S ADDRESS (street, city, state, and zip code)
CONTACT PERSON’S NAME
CONTACT PERSON’S E-MAIL ADDRESS
CONTACT’S DAYTIME TELEPHONE NO.
(
)
First Request for Extension
Second Request for Extension
FOR BOE USE ONLY
EXTENSION DATE
APPROVED
EXTENSION DATE
PROPERTY STATEMENT PARTS
(yes/no)
REQUESTED
GRANTED
Tangible Property List
Summary Control
Statement of Land Changes
Financial Schedules
Schedules of Leased Equipment
Studies and other voluntary information (specify)
Other requested information (describe below)
Reason for extension request (R & T Code section 830.1 requires a showing of good cause):
An extension is not automatically granted. You will be notified by mail whether the extension is granted or denied. If granted, the notice
will state the date to which the extension has been granted.
FAXED REQUEST to fax number: 916-285-0132 (If request is faxed, it must be followed by a hard copy through regular mail.)
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information herein,
including accompanying statements or documents, is true and correct and complete to the best of my knowledge and belief. If
the owner is a corporation, this document must be signed by an officer of the corporation.
APPLICANT’S SIGNATURE
DATE
SIGNATORY’S PRINTED NAME
TITLE
FOR BOARD USE ONLY
APPROVAL OR DISAPPROVAL BY BOE STATE-ASSESSED PROPERTIES DIVISION CHIEF
Approved as noted
Disapproved
STATE-ASSESSED PROPERTIES DIVISION CHIEF’S SIGNATURE
DATE
Comments:
FOR OFFICIAL USE ONLY
CLEAR
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