Fillable COLLEGE EXEMPTION CLAIM FOR ASSESSORS USE ONLY Received (County of Lake)

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COLLEGE EXEMPTION CLAIM FOR ASSESSORS USE ONLY Received (County of Lake)

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BROWSE COUNTY OF LAKE (CA) FORMS

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5. Does the institution confer upon its graduates at least one academic or professional degree, based on a course of at least two years in liberal arts
and sciences, or on a course of at least three years in professional studies, such as law, theology, education, medicine, dentistry, engineering,
veterinary medicine, pharmacy, architecture, ne arts, commerce, or journalism?
BOE-264-AH (P1) REV. 12 (05-16)
CLAIMANT NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address)
NAME OF CLAIMANT
ADDRESS (Street, City, County, State, Zip Code)
TITLE OF CLAIMANT
DAYTIME TELEPHONE NUMBER
( )
CORPORATE NAME OF THE COLLEGE
2. Does the above institution qualify as a college or seminary of learning under the laws of the State of California?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
3. Is the institution conducted as a non-prot entity?
4. Does the institution require for regular admission the completion of a four-year high school course or its equivalent?
6. Is the property for which the exemption is claimed used exclusively for the purposes of education?
Received by
of
on
FOR ASSESSOR’S USE ONLY
(Assessor’s designee)
(county or city)
(date)
ASSESSOR’S PARCEL NUMBER OR LEGAL DESCRIPTION DATE PROPERTY WAS FIRST USED BY CLAIMANT
COLLEGE EXEMPTION CLAIM
This claim is led for scal year 20 ____ - 20 ____.
This claim must be led by 5:00 p.m., February 15.
1. Owner and operator: (check applicable boxes)
Claimant is:
(Example: a person ling a timely claim in January 2011
would enter "2011-2012.")
Owner and operator
Operator only
Owner only
and claims exemption on all
Land Buildings and improvements
Personal propertyand/or
7.
List all buildings and other improvements for which exemption is claimed and state the primary and incidental use of each. Attach a separate
sheet if necessary. Indicate whether leased or owned. Please use a separate claim form for each Assessor's Parcel Number.
BUILDING & IMPROVEMENTS
PRIMARY USE INCIDENTAL USE
LEASE
LEASE
LEASE
LEASE
LEASE
LEASE
OWN
OWN
OWN
OWN
OWN
OWN
THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION
SIGNATURE OF PERSON MAKING CLAIM
BOE-264-AH (P2) REV. 12 (05-16)
8. Has any construction commenced and/or been completed on this parcel since 12:01 a.m., January 1 of last year?
YES
NO
If YES, please explain:
9. Is the property, or a portion thereof, for which an exemption is claimed a student bookstore that generates unrelated business taxable income
as dened in section 512 of the Internal Revenue Code?
YES
NO
If YES, a copy of the institution’s most recent tax return led with the Internal Revenue Service must accompany this claim. Property taxes,
as determined by establishing a ratio of the unrelated business taxable income to the bookstore’s gross income, will be levied.
10. Has any of the property listed above been used for business purposes other than a student bookstore?
YES
NO If YES, please explain:
11. If any business is operated by someone other than the college, attach a copy of the lease or other agreement. Please explain:
12. Is any equipment or other property being leased or rented from someone else?
YES
NO
If YES, list on a separate sheet the name and address of the owner and the type, make, model, and serial number of the property. If the
property listed is not used exclusively for educational purposes at the collegiate level, please state the other uses of the property. If real
property, provide the name and address of the owner.
The benet of a property tax exemption must inure to the lessee institution. If taxes paid by the lessor, see section 202.2 of the Revenue and
Taxation Code.
ADDITIONAL REQUIRED DOCUMENTATION
• Attach a separate page showing the requirements for admission. A current catalog showing the requirements may be
substituted.
• Attach a separate page, or current catalog, listing the degrees conferred upon the graduates and the requirements for each
degree.
• Attach a copy of the nancial statements (balance sheet and operating statement for the preceding scal year.)
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any
accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief.
NAME OF PERSON MAKING CLAIM
CERTIFICATION
t
TITLE
DATE
NAME
Whom should we contact during normal business hours for additional information?
DAYTIME TELEPHONE
( )
EMAIL ADDRESS
TITLE
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COLLEGE EXEMPTION CLAIM FOR ASSESSORS USE ONLY Received (County of Lake)

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Completed 6 August 2020

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