Form BOE-267-L-A, Lower Income Households Family Household Income Reporting Worksheet (140% AMI), is the statement in which a household reports its size and its income against the lower income limit and the 140 percent of area median income (AMI) limit. It is one of the Los Angeles County property tax forms that support Welfare Exemption claims on housing for lower income households, and the Los Angeles County Office of the Assessor lists it on its forms page. Tenants complete it and return it to the manager of the organization that provides the housing. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the original is published by the Assessor.
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What is BOE-267-L-A?
Form BOE-267-L-A, Lower Income Households Family Household Income Reporting Worksheet (140% AMI) is the worksheet in which a household reports its size and its income against the lower income limit and the 140% AMI limit.
AMI stands for area median income. The form's preamble ties the worksheet to section 214(g) of the California Revenue and Taxation Code: property owned by nonprofit organizations or eligible limited liability companies that provide housing for lower income households can qualify for the Welfare Exemption from property taxes for the units whose family household income does not exceed the stated limits. Under section 214(g)(2)(A)(iii) or (iv), units in property that receives low-income housing tax credits under Internal Revenue Code Section 42, or in property of a community land trust (CLT) leased to a lower income household, continue to qualify if the occupants were lower income when they first moved in and their income has since risen to no more than 140 percent of AMI. The form calls these occupants "over-income" tenants.
The household completes and signs the worksheet. The organization that provides the housing then uses the information to complete the form it must file with the County Assessor. The form is printed as BOE-267-L-A and also carries the Assessor's number ASSR-99.1; page 1 is the worksheet and page 2 holds the instructions and the lists of what counts as income.
The Assessor's forms page lists related worksheets: BOE-267-L-B, Lower Income Households Family Household Income Reporting Worksheet (100% AMI), and BOE-267-H-A, Elderly or Handicapped Families Family Household Income Reporting Worksheet. This page covers the 140% AMI version for lower income households.
Who needs to file BOE-267-L-A?
Households that live in a unit of housing provided by a nonprofit organization or eligible limited liability company completing this worksheet when the organization's manager asks for it. The form says to complete it, sign it and return it to the manager so the organization has time to complete the form it files with the County Assessor to claim the exemption on qualifying units.
- Occupants of the unit: one worksheet reports the household of that unit, with the address or unit number in Section 1 and the names of everyone in the household in Section 2.
- Over-income tenants: households that were lower income when they moved in but whose income has risen to no more than 140 percent of AMI report that in Section 3. This applies to property that receives low-income housing tax credits under Internal Revenue Code Section 42 and to community land trust property leased to a lower income household.
- Managers and officers of the organization: they receive the signed statement and are told on the form to keep it for their records.
The worksheet gives no rule for signing on someone else's behalf; the certification is made by the person who signs it. If your organization gives you the BOE-267-L-B (100% AMI) worksheet instead, use the version it asks for.
When to file BOE-267-L-A
Complete the worksheet as soon as the manager of the organization that provides your housing asks for it. The form says to complete, sign and return it promptly, so the organization has time to prepare the form it must file with the County Assessor to claim property tax exemption on qualifying units.
The worksheet prints no calendar due date of its own. Section 3 asks which income limit applies for the 20__ calendar year you fill in, and line 2 of Section 4 refers to the prior calendar year's household income, so have that year's income figures ready before you start.
How to fill out BOE-267-L-A
Enter your address or unit number
In Section 1, write the address or unit number of your household. The form says no P.O. Box numbers.
List everyone in the household
In Section 2, enter the names of the persons who make up your household. Count them: that count decides which row of the income limit table applies.
Add up your household income
Total the income of the household using the lists on page 2. Include wages, business and rental net income, interest and dividends, periodic Social Security or pension payments, unemployment and disability pay, alimony and child support, and the other items listed; leave out the excluded items such as casual gifts and medical reimbursements.
Find your limits in the table
In the Section 2 table, read the lower income limit and the 140% AMI limit in the row for your number of persons (1 to 8 are listed).
Check the income box in Section 3
Fill in the calendar year after the printed 20, then check one box: does not exceed the lower income limit, exceeds the lower income limit but is not greater than 140% of AMI, or exceeds the 140% AMI limit.
Enter the number of persons
In Section 4, line 1, enter the number of persons in the family household. It should match the persons listed in Section 2.
Enter the income limit on line 2
On line 2, enter the income limit shown for that number of persons: the lower income limit or the 140% AMI limit, matching the box you checked.
Sign, print your name and date
Under the certification, sign, print your name and enter the date. You certify under penalty of the laws of the State of California that the information is true, correct and complete to the best of your knowledge and belief.
Review and download the completed PDF
Check the address, names, box, number of persons, limit and signature, then download or print the completed PDF from FillingPDF and return it to the manager as described under How to submit.
How to submit BOE-267-L-A
The household returns the signed worksheet to the organization, not to the Assessor. The instructions say to promptly return the statement to an officer or the manager of the organization on whose property you reside.
- To the organization: give or send the signed worksheet to an officer or the manager of the organization that provides your housing. The form prints no mailing address, portal or appointment rule for tenants.
- Manager's copy: the form carries a note telling the manager to retain it for the organization's records.
- To the County Assessor: the organization, not the tenant, files the form that claims the exemption. The Los Angeles County Office of the Assessor publishes its forms at https://assessor.lacounty.gov/forms.
Before you hand it in, check that the certification is signed, your name is printed and the date is entered. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Entering a P.O. Box in Section 1; the form says no P.O. Box numbers, only the address or unit number of the household.
- Listing a different number of persons on line 1 of Section 4 than the names in Section 2; the form says the two numbers should match.
- Checking a Section 3 box without comparing household income to the limit for the number of persons in the household.
- Entering on line 2 a limit for the wrong household size, or the wrong type of limit (lower income or 140% AMI) for the box checked in Section 3.
- Counting excluded items as income, such as casual gifts, medical reimbursements, inheritances or scholarships paid to the student or school.
- Leaving out included income such as periodic Social Security or pension payments, alimony, child support or regular gifts from people not living in the dwelling.
- Signing without printing your name and dating the certification; the signature, printed name and date are all printed lines.
- Holding the worksheet instead of returning it promptly to the officer or manager of the organization on whose property you live.
Frequently asked questions
What is Form BOE-267-L-A used for?
Form BOE-267-L-A is a worksheet in which a household reports its size and whether its income is within the lower income limit or the 140% AMI limit. The organization that provides the housing uses it to complete the form it files with the County Assessor for the Welfare Exemption on qualifying units.
Who fills out the Lower Income Households worksheet, the tenant or the manager?
The household completes and signs it. The manager or an officer of the organization that provides the housing receives the signed statement and is told on the form to retain it for the organization's records.
Where do I send Form BOE-267-L-A?
Return it to an officer or the manager of the organization on whose property you live. The instructions say to return it promptly. The form gives tenants no Assessor address; the organization files its own exemption claim with the County Assessor.
What counts as household income on this worksheet?
Page 2 lists included income: wages and tips, net business or rental income, interest and dividends, periodic Social Security or pension payments, unemployment and disability pay, alimony and child support, and military pay. It also lists exclusions, such as casual gifts and medical reimbursements.
What does 140% AMI mean on the form?
AMI is area median income. The 140% AMI limit applies to "over-income" tenants of certain properties: those who were lower income when they first moved in but whose income has since risen to no more than 140 percent of AMI. The units can continue to qualify for the exemption.
Do I have to sign Form BOE-267-L-A?
Yes. The instructions tell you to sign the statement to certify its accuracy. You certify under penalty of the laws of the State of California that the information is true, correct and complete to the best of your knowledge and belief, then print your name and date it.
What is the difference between BOE-267-L-A and BOE-267-L-B?
The Assessor's forms page lists BOE-267-L-B as the same worksheet title for 100% AMI, while this form is the 140% AMI version. Use the version the organization that provides your housing asks you to complete.
Can I fill out Form BOE-267-L-A online?
You can complete the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not affiliated with the Los Angeles County Office of the Assessor, and it does not file or send the worksheet; you return it to the housing organization.
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