BOE-263-A

Source: https://www.boe.ca.gov/proptaxes/pdf/sample-boe263a.pdf

This page watermarked sample only. Contact Assessor for actual form. BOE-263-A (P1) REV. 08 (05-25)

QUALIFIED LESSORS’ EXEMPTION CLAIM PROPERTY USED FOR FREE PUBLIC LIBRARIES AND FREE MUSEUMS AND USED EXCLUSIVELY FOR PUBLIC SCHOOLS, COMMUNITY COLLEGES, STATE COLLEGES, STATE UNIVERSITIES, UNIVERSITY OF CALIFORNIA, AND NONPROFIT COLLEGES This claim must be filed by 5:00 p.m., February 15.

NAME AND MAILING ADDRESS (Make necessary corrections to the printed name and mailing address)

To receive one time reporting treatment for the exemption, this claim must be filed with the Assessor within 120 days of the commencement date of the lease.

IDENTIFICATION OF APPLICANT LESSOR’S CORPORATE OR ORGANIZATION NAMEMAILING ADDRESS Form

CITY, STATE, ZIP CODE

CORPORATE ID (IF ANY) ONLY

IDENTIFICATION OF PROPERTY ADDRESS OF PROPERTY (NUMBER AND STREET) FISCAL YEAR OF CLAIM Actual 20 – 20 CITY, COUNTY, ZIP CODE ASSESSOR’S PARCEL NUMBER for USE OF PROPERTY Check and state the primary and incidental qualifying uses of the property. The exemption claim is made for the following property: (if there are numerous properties, please attach a list that clearly identifies the property and the name and address of the lessee) PROPERTY TYPE PRIMARY USE INCIDENTAL USE Land

Buildings and Improvements SAMPLE
Personal Property Yes No The lease confers uponAssessorthe lessee the exclusive right to possession and use of the property.

Yes No As used herein a qualifying institution is one whose property qualifies for the free public library, free museum, public school, community college, state college, state university, University of California, or nonprofit college property tax exemption.

Yes No The lessee institution has the option at the end of the lease term of acquiring the above property described in the lease for $1 (one dollar) or any other nominal sum.

Important: A lessee’s affidavit, in which the lessee attests to the above statement(s) is provided. Failure to submit/complete the lessee’s affidavit will result in denial of one time reporting treatment for the exemption. A separate affidavit is required of each lessee. Contact

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 any accompanying statements or materials, is true, correct, and complete to the best of my knowledge and belief. SIGNATURE OF PERSON MAKING CLAIM DATE

NAME OF PERSON MAKING CLAIM TITLE

EMAIL ADDRESS DAYTIME TELEPHONE ( ) THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION

This page watermarked sample only. Contact Assessor for actual form.

BOE-263-A (P2) REV. 08 (05-25)

RETURN THIS AFFIDAVIT TO LESSOR AFFIDAVIT FOR EXECUTION BY QUALIFYING INSTITUTIONAL LESSEE

NAME OF QUALIFYING LESSEE INSTITUTION

MAILING ADDRESS

CITY, STATE, ZIP CODE

R Check the type of qualifying use of the property FREE PUBLIC LIBRARY COMMUNITY COLLEGE UNIVERSITY OF CALIFORNIA

FREE MUSEUM STATE COLLEGE NONPROFIT COLLEGE

PUBLIC SCHOOL STATE UNIVERSITY

NAME OF LESSOR Form MAILING ADDRESS

CITY, STATE, ZIP CODE ONLY COMMENCEMENT DATE OF LEASE DATE PROPERTY PUT TO EXEMPT USE PLEASE ATTACH A COPY OF THE ActualLEASE AGREEMENT The following property is leased as of January 1 of this year. If personal forproperty is being leased, indicate the type, make, model, serial number, etc. Attach a separate listing if necessary. PROPERTY TYPE PROPERTY DESCRIPTION (REAL OR PERSONAL) SAMPLE Assessor

Yes No The lessee institution has the option at the end of the lease term of acquiring the above property described in the lease for $1 Contact(one dollar) or any other nominal sum.

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 any accompanying statements or materials, is true, correct, and complete to the best of my knowledge and belief.

SIGNATURE OF PERSON MAKING CLAIM DATE t NAME OF PERSON MAKING CLAIM TITLE

EMAIL ADDRESS DAYTIME TELEPHONE ( ) THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION