Form BOE-267-L4 is the supplemental affidavit that owners of lower income rental housing file with the Los Angeles County Office of the Assessor to report tenants whose household income has risen above the lower income limit but does not exceed 100 percent of area median income (AMI). It is one of the Los Angeles County property tax exemption forms and is filed with the welfare exemption claim. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form itself is published by the Assessor.
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What is BOE-267-L4?
Welfare Exemption Supplemental Affidavit, Households Exceeding Low-Income Limits Over-Income Tenant Data (100% AMI), Form BOE-267-L4, is the affidavit a claimant files with the county assessor to keep a unit treated as lower income housing when the occupants' income has risen above the lower income limit but stays within 100 percent of AMI.
The form supports a welfare exemption claim under Revenue and Taxation Code sections 214(g)(2)(A)(iii) and 259.15. Under those provisions a unit continues to count as occupied by a lower income household when three conditions are met: the household income is no more than 100 percent of AMI, adjusted for family size; the occupants were a lower income household on the lien date when occupancy first began; and the unit remains rent-restricted.
Section 1 identifies the organization and the property. Section 2 is a table listing each qualifying unit with its household size, annual household income, maximum allowable rent, actual rent charged and the percentage of AMI from which the maximum rent is derived. A certification under penalty of perjury follows.
The instructions say these provisions apply only to lower income rental housing subject to an enforceable and verifiable agreement with a public agency and owned and operated by a nonprofit organization, an eligible limited liability company, or a limited partnership with an eligible managing general partner. The assessor keeps the form confidential.
It supplements BOE-267 (first filing) or BOE-267-A (annual filing), and it follows BOE-267-L or BOE-267-L1, on which you check the box in Section 4.A2.
Who needs to file BOE-267-L4?
You must complete this affidavit if you checked the box in Section 4.A2 of BOE-267-L or BOE-267-L1, showing that you are seeking exemption on a unit under Revenue and Taxation Code section 214(g)(2)(A)(iii). The instructions state that failing to file it results in denial of the exemption.
The form applies to:
- owners of lower income rental housing property that is subject to an enforceable and verifiable agreement with a public agency;
- where the property is owned and operated by a nonprofit organization, an eligible limited liability company, or a limited partnership with an eligible managing general partner;
- for units whose occupants met the lower income threshold on the lien date in the fiscal year occupancy began, and whose household income later rose above that limit without exceeding 100 percent of AMI.
List every unit that was counted in Section 4.C2 of BOE-267-L or BOE-267-L1 (units occupied by households exceeding lower income limits but not exceeding 100% AMI). A separate affidavit is required for each location on which you seek exemption under this provision. The form is signed by the claimant.
When to file BOE-267-L4
The affidavit must be filed by 5:00 p.m., February 15, with the county assessor. The instructions say filing by February 15 avoids the late-filing penalty provided by Revenue and Taxation Code section 270.
Enter the fiscal year that follows the January 1 lien date (12:01 a.m.) for which the property's status is being decided. The instructions give an example: a timely claim filed in February 2018 shows fiscal year 2018-2019, while an entry of 2017-2018 on a form filed in February 2018 signals a late claim for the preceding year.
Because the form supplements BOE-267 or BOE-267-A, file it with that claim. It has no separate due date printed beyond the February 15 deadline.
Documents you need
- The welfare exemption claim this affidavit supplements: BOE-267, Claim for Welfare Exemption (First Filing), or BOE-267-A, Claim for Welfare Exemption (Annual Filing).
- Additional sheets, only if the Section 2 table does not have room for every qualifying unit.
How to fill out BOE-267-L4
Enter the fiscal year
At the top, enter the fiscal year in the form "20 __ – 20 __": the fiscal year that follows the January 1 lien date being determined.
Confirm the claim it supplements
The form is a supplemental affidavit for BOE-267 (First Filing) or BOE-267-A (Annual Filing). File it with whichever claim applies.
Identify the organization
In Section 1, enter the Name of Organization and its Corporate ID or LLC Number, as assigned by the California Secretary of State.
Enter the property location
In Section 1, enter the Address of Property (number and street), then City, County, Zip Code and the Assessor's Parcel/Assessment Number(s).
List each qualifying unit
In Section 2.A, give the Address/Unit Number of every unit that was included in Section 4.C2 of BOE-267-L or BOE-267-L1. Attach additional sheets if needed.
Enter household size and income
For each unit, enter the No. of Persons in Household and the Annual Household Income.
Enter rent and AMI figures
For each unit, enter the Maximum Allowable Rent That Can Be Charged to the Tenant, the Actual Rent Charged for the Unit and the Percentage of AMI From Which Maximum Rent Charged is Derived.
Complete the certification
Enter the Name of Claimant, Title and Date, then the signature, daytime telephone and email address. The certification is made under penalty of perjury under California law.
Review and download the PDF
Check that every unit, income and rent entry is complete and that the form covers one location only. Download or print the completed PDF from FillingPDF and file it as described under How to submit.
How to submit BOE-267-L4
The form is filed with the county assessor, together with the welfare exemption claim it supplements: BOE-267 for a first filing or BOE-267-A for an annual filing. It must be filed by 5:00 p.m., February 15.
- Where: the instructions direct the filing to the county assessor. For property in Los Angeles County, that is the Los Angeles County Office of the Assessor, which lists its forms at https://assessor.lacounty.gov/forms.
- One per location: file a separate affidavit for each location on which you seek exemption under section 214(g)(2)(A)(iii).
- Extra sheets: if the Section 2 table is too short, attach additional sheets.
The form prints no mailing address, portal or appointment rule of its own, and it names no fee. Contact the Assessor through its website for filing details. FillingPDF lets you fill out and download the PDF; submission follows the Assessor's channels.
Common mistakes to avoid
- Not filing this affidavit after checking the box in Section 4.A2 of BOE-267-L or BOE-267-L1; the instructions say failure to file results in denial of the exemption.
- Filing after 5:00 p.m. on February 15, which exposes the claim to the late-filing penalty under Revenue and Taxation Code section 270.
- Entering the wrong fiscal year; a prior-year entry on a form filed in February signals a late claim for the preceding year.
- Combining several properties on one affidavit; a separate affidavit is required for each location.
- Leaving out units that were counted in Section 4.C2 of BOE-267-L or BOE-267-L1 instead of listing every one in Section 2.
- Listing a unit whose occupants did not initially meet the lower income limit or that is no longer rent restricted.
- Submitting the affidavit without the name, title, date and signature of the claimant in the certification block.
- Omitting the Corporate ID or LLC number in Section 1 for an organization that has one.
Frequently asked questions
What is Form BOE-267-L4 used for?
BOE-267-L4 is the supplemental affidavit that lists units occupied by households whose income has risen above the lower income limit but does not exceed 100 percent of AMI. It supports a welfare exemption claim under Revenue and Taxation Code sections 214(g)(2)(A)(iii) and 259.15.
When is BOE-267-L4 due?
By 5:00 p.m., February 15. The instructions say filing by that date avoids the late-filing penalty under Revenue and Taxation Code section 270. The form is filed with the county assessor along with the welfare exemption claim it supplements.
Do I have to file BOE-267-L4 with my welfare exemption claim?
Yes, if you checked the box in Section 4.A2 of BOE-267-L or BOE-267-L1 to seek exemption on a unit under section 214(g)(2)(A)(iii). The instructions state that failing to file this form results in denial of the exemption.
Do I need a separate BOE-267-L4 for each property?
Yes. The instructions require a separate affidavit for each location on which you are seeking exemption under Revenue and Taxation Code section 214(g)(2)(A)(iii). Use additional sheets only for more units at the same location.
Is the information on BOE-267-L4 public?
No. The form is marked confidential and not subject to public disclosure, and the instructions say the assessor shall keep it confidential under Revenue and Taxation Code section 259.15.
What is the difference between BOE-267-L4 and BOE-267-L3?
Both are Los Angeles County Assessor supplemental affidavits for over-income tenant data. BOE-267-L4 is the version titled for households up to 100% AMI, and it is the form that follows BOE-267-L or BOE-267-L1 when section 214(g)(2)(A)(iii) is checked.
Can I fill out BOE-267-L4 online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the affidavit with the Assessor; you file it through the Assessor's channels with your welfare exemption claim.
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