Form Boe-516 - Wireless Communication Sites Page 2

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BOE-516 (BACK) REV. 10 (12-12)

Report all sites whether subject to local or state assessment jurisdiction acquired during Calendar Year 2012. If there were no sites acquired during the year, enter “none” in

column D and return this form with your property statement filing.

If you have questions regarding this form, or need instructions on filing electronically, please contact the State-Assessed Properties Division, Wireless Communications lead person.

INSTRUCTIONS

Column A.

Enter the SBE map number if the land is subject to state assessment.

Column B.

Enter the date of the lease inception.

Column C.

Enter the Assessor’s Parcel Number (APN) of the property upon which the site is located, if available.

Column D.

Enter the street address and city of the site. Either column C or column D must be completed for each site.

Column E.

Enter the name of the lessor.

Column F.