REQUEST TO REMOVE THE OWNER’S NAME FROM THE ASSESSMENT ROLL
[Public Safety Officials Only]
Date:
To: COUNTY OF SAN BERNARDINO
ASSESSOR’S OFFICE
222 W Hospitality Lane
San Bernardino,
CA 92415-0311
Attn: Transfers Section
From:
RE: Parcel #
As a public safety official (as defined in Government Code section 6254.24), I am concerned
about my name appearing on the property tax assessment rolls of San Bernardino County.
Given the nature of the business I am involved in, there is reason for concern about the
personal safety for my family and me. I believe that disclosure of my name on the assessment
roll may subject me or my family members to a risk of bodily injury and thereby interfere with
the due administration of justice. For these reasons, I request that the Assessor’s Office not
display my name as the current owner of the parcel noted above on the assessment rolls and
any of the Assessor Information Systems.
I make this request with the full understanding the property ownership will be changed to a
unique number identifying my ownership in this parcel, that the mailing address will remain as it
is (unless I submit an address change request in writing), that I may rescind this request in
writing at a later date, and that I assume full responsibility for the timely payment of all tax
billings whether a bill is delivered to my address or not.**
Signature:
Title/Position:
Date:
Please attach your business card and a photocopy of Identification Badge. Other forms of
proof of employment and property ownership will also be accepted.
** Suggestion: If you do not receive the annual tax bill by November 1
st
, contact the Treasurer-
Tax Collector’s Office at (909) 387-8308. If your mortgage company pays your taxes through
an impound account, you should receive a “Courtesy Bill” from the Tax Collector.
ACO 031 Rev. (09-20) Confidential
BOB DUTTON
ASSESSOR-RECORDER-COUNTY CLERK
COUNTY OF SAN BERNARDINO
ASSESSOR’S OFFICE
222 W Hospitality Lane
San Bernardi
no, CA 92415-0311
www.s
bcountyarc.org
(909) 382-3294
