BOE-571-R (P3) REV. 22 (05-19)
INSTRUCTIONS
The Revenue and Taxation Code of the State of California requires that every person, upon request of the Assessor, shall
le a written property statement under penalty of perjury with the Assessor within such time as the Assessor may appoint.
Please complete this form according to the numbered instructions provided below as your statement of furnishings and related
equipment owned, possessed or controlled by you as of 12:01 a.m., January 1, this year at the location listed. Property which you
are purchasing under a conditional sales contract must be included. Return the completed statement form to the Assessor
on or before the date stated in the ofcial requirement section. In all instances, you must return the original BOE-571-R.
LINE 3. PROPERTY TRANSFER
Real Property – For purposes of reporting a change in control, real property includes land, structures, or xtures owned or held
under lease from (1) a private owner if the remaining term of the lease exceeds 35 years, including written renewal options, (2) a
public owner (any arm or agency of local, state, or federal government) for any term or (3) mineral rights owned or held on lease
for any term, whether in production or not.
Controlling Interest – When any person or legal entity obtains more than 50 percent of the voting stock of a corporation, or more
than a 50 percent ownership interest in any other type of legal entity. The interest obtained includes what is acquired directly or
indirectly by a parent or afliated entity.
Forms, Filing Requirements & Penalty Information – Contact the Legal Entity Ownership Program Section at
916-274-3410 or refer to the Board’s website at www.boe.ca.gov to obtain form BOE-100-B, applicable ling requirements, and
penalty information.
LINE 4. Check the appropriate box. If yes is checked, enter the name and address of the owner of the furniture or equipment.
Briey describe the nature of the business or property. Do not report household furnishings owned by tenants and used
in their living quarters, or other personal property owned or controlled by tenants.
LINE 5. Check the appropriate box. If yes is checked, enter the name and address of the owner or lessor and the quantity and
description of the furniture or equipment. The lessor of the items will be asked to declare them.
LINE 6. Enter the number of fully furnished, partly furnished, and unfurnished units in the appropriate column or columns. If the
owner of the building (other than a corporation) occupies a unit as his living quarters, do not include it. Please indicate
in the REMARKS area the items contained in a typical PARTLY FURNISHED apartment of each size. A sleeping room
is a room with no kitchen facilities; a studio contains a kitchen and a convertible living room; a 1 bedrm. contains a
bedroom, living room, kitchen, etc. Attach additional sheets if necessary.
LINE 7. Enter the cost of supplies that are on hand at 12:01 a.m. on January 1 of this year. Include janitorial and pool supplies,
whether carried in your asset accounts or expensed.
LINES 8 and 9. Enter the total cost from Schedules A and B.
SCHEDULE A. Complete the schedule as instructed. If a portion of the furniture used in your rental units has been placed in
storage, include the cost in the schedule and enter in the remarks the address where stored. Do not include
built-in appliances, installed carpeting, or drapes as furniture; such items are considered part of the building.
Include ranges, refrigerators, dishwashers, etc., if not built-in.
SCHEDULE B. Complete the schedule as instructed. Include all equipment not reported in Schedule A. If you care to attach
a schedule listing types of equipment separately, you may do so.
DECLARATION BY ASSESSEE
The law requires that this property statement, regardless of where it is executed, shall be declared to be true under penalty of
perjury under the laws of the State of California. The declaration must be signed by the assessee, a duly appointed duciary,
or a person authorized to sign on behalf of the assessee. In the case of a corporation, the declaration must be signed by an
ofcer or by an employee or agent who has been designated in writing by the board of directors, by name or by title, to sign the
declaration on behalf of the corporation. In the case of a partnership, the declaration must be signed by a partner or an authorized
employee or agent. In the case of a Limited Liability Company (LLC), the declaration must be signed by an LLC manager, or
by a member where there is no manager, or by an employee or agent designated by the LLC manager or by the members to
sign on behalf of the LLC.
When signed by an employee or agent, other than a member of the bar, a certied public accountant, a public accountant, an
enrolled agent or a duly appointed duciary, the assessee’s written authorization of the employee or agent to sign the declaration
on behalf of the assessee must be led with the Assessor. The Assessor may at any time require a person who signs a property
statement and who is required to have written authorization to provide proof of authorization.
A property statement that is not signed and executed in accordance with the foregoing instructions is not validly led. The penalty
imposed by section 463 of the Revenue and Taxation Code for failure to le is applicable to unsigned property statements.
THIS STATEMENT IS NOT A PUBLIC DOCUMENT. THE INFORMATION DECLARED
WILL BE HELD SECRET BY THE ASSESSOR.
