BOE-65-PT (P1) REV. 06 (01-12) CLAIM FOR INTERCOUNTY TRANSFER OF BASE YEAR VALUE TO REPLACEMENT PROPERTY FROM PRINCIPAL RESIDENCE DAMAGED OR DESTROYED IN A GOVERNOR-DECLARED DISASTER A. REPLACEMENT PROPERTY: ASSESSOR'S PARCEL NUMBER PROPERTY ADDRESS DATE OF PURCHASE PURCHASE PRICE CITY RECORDER'S DOCUMENT NUMBER COST OF NEW CONSTRUCTION DATE OF COMPLETION OF NEW CONSTRUCTION Is this property your principal place of residence? B. ORIGINAL (FORMER) PROPERTY: ASSESSOR'S PARCEL NUMBER PROPERTY ADDRESS Yes No DATE OF DISASTER CITY COUNTY Was this property your principal place of residence? Yes No NOTE: You must attach a copy of the original property's latest tax bill and any supplemental tax bill(s) issued before the date of the disaster. Was there any new construction to the original property between the date of those tax bill(s) and the date of disaster? If Yes, please explain: Yes No C. CLAIMANT INFORMATION NAME OF CLAIMANT I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing, and all information hereon, is true, correct, and complete to the best of my knowledge and belief. SIGNATURE OF CLAIMANT MAILING ADDRESS CITY, STATE, ZIP DATE DAYTIME PHONE NUMBER W ( ) EMAIL ADDRESS $OO LQIRUPDWLRQ SURYLGHG RQ WKLV FODLP LV VXEMHFW WR YHUL¿FDWLRQ ,I \RX KDYH DQ\ TXHVWLRQV DERXW WKLV IRUP SOHDVH FRQWDFW WKH $VVHVVRU¶V RI¿FH THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION American LegalNet, Inc. www.FormsWorkFlow.com BOE-65-PT (P2) REV. 06 (01-12) 2:1 5(9  GENERAL INFORMATION California law allows any individual or individuals who reside in an original property (i.e., principal place of residence) to transfer the base year value of the original property that has been substantially damaged of destroyed by a disaster to a replacement property (i.e., principal place of residence) of equal or lesser value in another county that has adopted an ordinance allowing such transfers. 7KH IROORZLQJ UHTXLUHPHQWV PXVW EH PHW 1. 2. 3. WKH GLVDVWHU PXVW EH D PDMRU PLVIRUWXQH RU FDODPLW\ LQ DQ DUHD VXEVHTXHQWO\ SURFODLPHG E\ WKH *RYHUQRU WR EH LQ D VWDWH RI disaster as a result of the misfortune or calamity; WKH UHSODFHPHQW SURSHUW\ PXVW KDYH EHHQ DFTXLUHG RU QHZO\ FRQVWUXFWHG ZLWKLQ WKUHH \HDUV DIWHU WKH GDWH RI WKH GLVDVWHU (including land); D FODLP IRU UHOLHI PXVW EH ¿OHG within three years DIWHU WKH UHSODFHPHQW SURSHUW\ LV DFTXLUHG RU QHZO\ FRQVWUXFWHG Property is substantially damaged if the land or the improvements sustain physical damage amounting to more than 50 percent of its full cash value immediately prior to the disaster. ,Q JHQHUDO ³HTXDO RU OHVVHU YDOXH´ PHDQV WKH IDLU PDUNHW YDOXH RI D UHSODFHPHQW SURSHUW\ RQ WKH GDWH RI SXUFKDVH RU FRPSOHWLRQ of construction does not exceed: 1. SHUFHQW RI IXOO FDVK YDOXH RU IDLU PDUNHW YDOXH RI WKH RULJLQDO SURSHUW\ LPPHGLDWHO\ SULRU WR WKH GDWH RI GLVDVWHU LI D replacement property is purchased or newly constructed within the ¿UVW \HDU following the date of the damage or destruction of the original property; SHUFHQW RI IXOO FDVK YDOXH RU IDLU PDUNHW YDOXH RI WKH RULJLQDO SURSHUW\ LPPHGLDWHO\ SULRU WR WKH GDWH RI GLVDVWHU LI D replacement property is purchased or newly constructed within the second year following the date of the damage or destruction of the original property; or SHUFHQW RI IXOO FDVK YDOXH RU IDLU PDUNHW YDOXH RI WKH RULJLQDO SURSHUW\ LPPHGLDWHO\ SULRU WR WKH GDWH RI GLVDVWHU LI D replacement property is purchased or newly constructed within the third year following the date of the damage or destruction of the original property. 2. 3. TRANSFERS BETWEEN COUNTIES ARE ALLOWED ONLY IF THE COUNTY IN WHICH THE REPLACEMENT PROPERTY IS LOCATED HAS PASSED AN AUTHORIZING ORDINANCE. 7KH DFTXLVLWLRQ RI DQ RZQHUVKLS LQWHUHVW LQ D OHJDO HQWLW\ WKDW GLUHFWO\ RU LQGLUHFWO\ RZQV UHDO SURSHUW\ LV QRW DQ DFTXLVLWLRQ RI replacement property under the law. American LegalNet, Inc. www.FormsWorkFlow.com