Fillable COUNTY OF LAKE RICHARD A. FORD CLAIM FOR (County of Lake)

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COUNTY OF LAKE RICHARD A. FORD CLAIM FOR (County of Lake)

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BROWSE COUNTY OF LAKE (CA) FORMS

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COUNTY OF LAKE
COUNTY ASSESSOR-RECORDER
Courthouse - 255 N. Forbes Street
Lakeport, California 95453
Assessor’s Office 707 / 263-2302
Recorder’s Office 707 / 263-2293
Fax 707 / 263-3703
RICHARD A. FORD
ASSESSOR-RECORDER
CLAIM FOR NEW CONSTRUCTION EXCLUSION FROM
SUPPLEMENTAL ASSESSMENT
This form must be filed with the Assessor prior to, or within 30 days of, the commencement of
construction.
Name_________________________________________________________________________
Address_______________________________________________________________________
City______________________________________State__________________Zip____________
New Construction Property Description
Parcel No. (s)___________________________________________________________________
Property Address________________________________________________________________
STATEMENT
I am the owner of the property described herein, I will commence construction site development or
structure(s) on this property on__________________________, and therefore claim the construction
exclusion from Supplemental Assessment provided by Section 75.12 of the California Revenue and
Taxation Code.
I currently offer, or intend to offer, the property for sale or other change in ownership and do not intend to
rent, lease, occupy, or otherwise use the property, except as model homes or other use as is incidental to
an offer for a change of ownership.
I understand that this exclusion shall apply only to Supplemental Assessment regarding new construction
on this property and shall not preclude the reassessment of any such property on the assessment roll for
the January 1
st
lien date following the date of completion of construction or to any other Supplemental
Assessment on this property.
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing
statements are true and correct.
Date_____________________Signature______________________________________________
Telephone No. (daytime)__________________________________________________________
Only the owner or a co-owner of the above described property (including a purchaser under contract of
sale) or his legal representative may sign.
If you are buying this property under an unrecorded contract of sale and the Assessor does not have a
copy of the contract, you must attach a copy of the claim.
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County of Lake pg. 2
GENERAL INFORMATION
Section 75.12 of the California Revenue and Taxation Code provides that any real property on which new
construction i
s completed and which qualifies for the exclusion under Section 75.12 shall not be added to
the supplemental roll until the date that property, in whole or in part:
(A) Changes ownership.
(B) Is rented or leased, or
(C) Is occupied o
r otherwise used by the owner or with the owner’s consent, except a model home or
other use which is incidental to an offer for a change of ownership, whichever comes first.
This exclusion applies only if the owner notifies the Assessor in writing pri
or to, or within 30 days of, the
commencement of construction that he or she offers or intends to offer that property for sale or other
change of ownership, and does not intend to rent, lease, occupy or otherwise use that property, except
model homes or other use as is incidental to an offer for a change of ownership, and the owner requests
the application of this section.
The owner of any real property granted this exclusion
shall notify the Assessor within 45 days of the
earliest date that any of the following occur:
(1) The propert
y changes ownership subject to an unrecorded contract of sale.
(2) The property
is rented or leased.
(3) The propert
y is occupied and the occupancy of the property is other than as a model home or
incidental to an offer for a change of ownership.
Failure to timely notify the Assessor in a timely manner, as described above, m
ay result in a penalty of
one hundred dollars ($100.00) or 10% of the taxes applicable to the new base year value, whichever is
greater, not to exceed two thousand five hundred dollars ($2,500.00)
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COUNTY OF LAKE RICHARD A. FORD CLAIM FOR (County of Lake)

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Completed 6 August 2020

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