Form BOE-267-R, Welfare Exemption Supplemental Affidavit, Rehabilitation – Living Quarters, is the affidavit an organization files with the Riverside County Assessor-County Clerk-Recorder when its welfare exemption claim covers property used to rehabilitate people or to provide living quarters. It is one of the Riverside County property tax forms that supplements a claim: it is filed with Form BOE-267 or Form BOE-267-A, not on its own. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form is published by the county at the official PDF link, and filing follows the county's channels.
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What is BOE-267-R?
Form BOE-267-R, Welfare Exemption Supplemental Affidavit, Rehabilitation – Living Quarters, is the supplemental affidavit an organization files with the county assessor to support a welfare exemption claim on property that involves rehabilitation of persons or living quarters.
The form is required under sections 251 and 254.5 of the California Revenue and Taxation Code, according to the instructions printed on it. It supplements the claim for welfare exemption, so it travels with one of two claim forms: BOE-267, Claim for Welfare Exemption (First Filing) or BOE-267-A, Claim for Welfare Exemption (Annual Filing). This copy is published by the Riverside County Assessor-County Clerk-Recorder.
The affidavit has four sections:
- Section 1: identification of the applicant organization, including its Organizational Clearance Certificate (OCC) number.
- Section 2: identification of the property.
- Section 3: rehabilitation activities such as a thrift shop, workshop, manufacturing or similar work, with counts of persons being rehabilitated, staff, hours and wages.
- Section 4: housing and living quarters, including who was housed on the last night in December and whether they pay, donate or work for room and board.
It ends with a certification signed under penalty of perjury. The form states that it is subject to public inspection.
Who needs to file BOE-267-R?
Organizations that are seeking a welfare exemption on property that involves rehabilitation of persons and/or living quarters file this affidavit with their claim. The instructions say it must be filed in that situation, and that if you do not complete and file it, you may be denied the exemption.
- Complete Section 3 for rehabilitation activities such as a thrift shop, workshop, manufacturing or similar work.
- Complete Section 4 only if the organization provides housing for persons being rehabilitated and/or living quarters for staff.
- File a separate affidavit for each location.
The form is not a stand-alone claim. It is filed with Form BOE-267 (first filing) or Form BOE-267-A (annual filing). An organization without an OCC is asked on the form whether it has filed an OCC claim with the BOE; the instructions point to Form BOE-277, Claim for Organizational Clearance Certificate – Welfare Exemption, for those who need to apply. The form names no other person who may sign for the organization beyond the name and title lines of the certification.
When to file BOE-267-R
The affidavit must be filed by 5:00 p.m. on February 15. The instructions say it must reach the county assessor by February 15 to avoid a late filing penalty under section 270, and the form carries the same deadline in its header. It is filed with the claim it supplements, Form BOE-267 or Form BOE-267-A.
Enter the fiscal year correctly. The proper fiscal year follows the lien date (12:01 a.m., January 1) on which the property's taxable or exempt status is determined. For example, a timely claim filed in February 2011 would show "2011-2012"; entering "2010-2011" on a claim filed in February 2011 would signify a late claim for the preceding fiscal year.
Several answers are measured on set dates: employees on the premises as of January 1 (Section 3) and persons housed on the last night in December (Section 4).
Documents you need
- Copy of the Organizational Clearance Certificate (OCC), if this is the first filing; the form asks for the OCC number and a copy of the certificate with the claim.
- Copy of the organization's formal rehabilitation program, or a separate attachment describing the rehabilitation program and activities in detail (Section 3).
- Copy of the contract or other document showing the basis for the salary or fee, only if a person, management firm or entity other than the filing organization operates the facility (Section 3, item E).
- Written explanation of why housing or living quarters are necessary, only if you answer Yes to whether housing or living quarters are provided (Section 3, item F).
- List describing the jobs performed and the number of persons involved, for the staff members necessary to care for persons being rehabilitated (Section 4, item A.3).
- Explanation in enough detail to determine the monthly fee per person, for each Yes answer on whether residents or staff pay, donate or work for room and board (Section 4, items C to F).
How to fill out BOE-267-R
Enter the fiscal year
At the top, complete "This claim is filed for fiscal year 20__ — 20__". The fiscal year follows the January 1 lien date; a timely February claim uses the year that begins that January.
Identify the applicant organization
Section 1: enter the Name of Organization, mailing address, city, state and ZIP code, and the Corporate ID or LLC Number. Enter the OCC No. and mark Yes or No to whether you filed an OCC claim with the BOE if you have no OCC.
Identify the property
Section 2: enter the property address, the Assessor's Parcel/Assessment Number(s), the city, county and ZIP code, and the Date Property Acquired.
Attach the rehabilitation program
Section 3 covers thrift shop, workshop, manufacturing or similar activities. Attach a copy of the formal rehabilitation program, or describe the program and activities in detail on a separate sheet.
Complete facility information (3.A)
Enter weekly operating hours and total persons employed on the premises on January 1. Give full-time and part-time counts of persons being rehabilitated, broken down by length of employment, and of staff and/or others.
Report off-premises employment (3.B)
Enter the full-time and part-time persons being rehabilitated, with the length-of-employment breakdown, and staff and/or others employed off the premises but in the facility's operations as of January 1.
Enter hours, salaries and wages
Items 3.C and 3.D: for persons being rehabilitated and for staff and/or others, enter hours worked, salaries and wages, and the number of persons involved for the period covered by the accompanying financial statements.
Answer the operator question
Item 3.E: mark Yes or No. If Yes, enter the operator's name and mailing address and the amount of salary or fee, and attach the contract or other document showing its basis.
Answer the housing question
Item 3.F: mark Yes or No. If Yes, explain the necessity and complete Section 4.
Count people housed on December's last night
Section 4, item A: enter persons being rehabilitated, unoccupied beds, staff necessary to care for them (attach the job list), other staff, and other persons not directly connected with the program. Include persons temporarily away.
Enter length of stay
Section 4, item B: list the number of persons housed by length of stay, from less than 6 months to 2 years or longer. Enter the total on B.2, which must agree with A.1.
Answer the room-and-board questions
Section 4, items C to F: mark Yes or No for each group. For each Yes, indicate whether they pay, donate or work, and explain enough to determine the monthly fee per person.
Complete contact details and certification
Enter whom to contact during business hours, with daytime telephone and email. Then enter your name, title, date and signature on the certification made under penalty of perjury.
Review and download the completed PDF
Check that totals agree and attachments are ready. Download or print the completed PDF from FillingPDF, then assemble it with Form BOE-267 or BOE-267-A as described under How to submit.
How to submit BOE-267-R
The Riverside County Assessor-County Clerk-Recorder takes this affidavit by mail or in person; the county states that its forms do not allow online submission.
- By mail: Riverside County Assessor-County Clerk-Recorder, PO BOX 751, RIVERSIDE, CA 92502-0751, as printed on the form.
- In person: deliver it to your local Assessor-County Clerk-Recorder office.
File it with the claim it supplements (Form BOE-267 or Form BOE-267-A) and include the attachments the form calls for. It must be received by 5:00 p.m. on February 15. The county asks that forms be printed in black ink on 8 1/2" x 11" white paper. Questions can go to the office at (951) 413-2757 or through www.rivcoacr.org. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Filing after 5:00 p.m. on February 15; the instructions tie a late filing penalty under section 270 to missing that date.
- Entering the wrong fiscal year, such as the preceding year on a February claim, which signals a late claim for that earlier year.
- Using one affidavit for several properties; the instructions require a separate affidavit for each location.
- Submitting the affidavit alone instead of with Form BOE-267 or Form BOE-267-A, which it supplements.
- Leaving out the OCC copy on a first filing, or the rehabilitation program copy or detailed description for Section 3.
- Giving a Section 4, item B.2 total that does not match the number of persons being rehabilitated in item A.1; the form says the figures must agree.
- Answering Yes to the operator, housing or room-and-board questions without the contract, explanation or monthly fee detail the form asks for.
- Trying to submit the form online; the county's forms must be delivered by mail or in person, printed in black ink on 8 1/2" x 11" white paper.
- Omitting the signature, name, title or date on the certification.
Frequently asked questions
What is Form BOE-267-R used for?
Form BOE-267-R is a supplemental affidavit filed with a welfare exemption claim when the property involves rehabilitation of persons and/or living quarters. It supplements Form BOE-267 (first filing) or Form BOE-267-A (annual filing) and is filed with the county assessor.
What is the deadline for Form BOE-267-R in Riverside County?
5:00 p.m. on February 15. The instructions say the affidavit must be filed with the county assessor by that date to avoid a late filing penalty under section 270, and that failing to complete and file it may lead to denial of the exemption.
Do I need a separate BOE-267-R for each property?
Yes. The instructions state that a separate affidavit must be filed for each location. Each affidavit identifies one property in Section 2, with its address, parcel or assessment number and acquisition date.
Can I submit Form BOE-267-R online to the Riverside County Assessor?
No. The county says its forms do not allow online submission and must be delivered by mail or in person. You can fill out the PDF online on FillingPDF and download it; FillingPDF does not file it with the county.
Where do I mail the welfare exemption supplemental affidavit?
Mail it to Riverside County Assessor-County Clerk-Recorder, PO BOX 751, RIVERSIDE, CA 92502-0751, the address printed on the form, or deliver it in person to your local office. The office phone number on the form is (951) 413-2757.
What do I attach to Form BOE-267-R?
Attach a copy of your formal rehabilitation program (or a detailed description), plus the OCC copy on a first filing. Add the operator contract, housing explanation, staff job list and room-and-board explanations only where the form's Yes answers call for them.
Which fiscal year do I enter on Form BOE-267-R?
Enter the fiscal year that follows the January 1 lien date. A timely claim filed in February 2011 would show 2011-2012; entering 2010-2011 on that claim would signify a late claim for the preceding fiscal year.
What if I do not have an Organizational Clearance Certificate?
Mark whether you have filed an OCC claim with the BOE in Section 1. If not, the instructions point to Form BOE-277, Claim for Organizational Clearance Certificate – Welfare Exemption, on www.boe.ca.gov or from the Welfare Exemption Section at 1-916-274-3430.
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