APP-004, Business Property Statement Request / Account Number and BIN Request, is the San Bernardino County Assessor-Recorder-County Clerk form for asking the Assessor's Office to send a 571-L Business Property Statement and to provide an account number and BIN. It is one of the San Bernardino County property tax forms handled by the Assessor, and it identifies the business, its property and a contact person. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the county publishes the original PDF at arc.sbcounty.gov.
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What is APP-004?
APP-004, Business Property Statement Request / Account Number and BIN Request, is a one-page San Bernardino County Assessor-Recorder-County Clerk form on which a business owner asks the Assessor's Office for a 571-L Business Property Statement and for an account number and BIN number.
The form is headed "Request for 571-L Business Property Statement" and "Request Account number and BIN number." It does not report property values. It identifies the property and the business so the Assessor's Office can set up the request: the Assessor's Parcel Number, the location of the property, the business owner name, the doing-business-as name, the type of business, the start date of the business at that location and the mailing address. A contact person is listed in case the office has questions.
The county's forms page lists APP-004 under the Assessor and shows it next to other business property forms, such as APP-144, Notification to the Assessor of Business in San Bernardino County, and APP-149, Report a Change on Business Property, Aircraft, and Boats. Those are separate forms with their own titles. The same page lists 2026 BOE-571-L Instructions as a separate document, which is the instruction sheet for the 571-L statement this form requests.
The printed revision is APP 004 Rev. (01-25).
Who needs to file APP-004?
The form is for business owners in San Bernardino County who want the Assessor's Office to send them a 571-L Business Property Statement and provide an account number and BIN for a business at a specific property. The form asks for the owner's name, any doing-business-as name, the type of business and the date the business started at that location, so it is written for the owner or operator of a business.
A contact person completes the last block: print name, title, daytime phone number, date and email. The form asks for the title because the person who answers the Assessor's questions may differ from the owner, but it prints no rule on who may complete or sign for the owner.
The form is a request, not a statement of property. The county's forms page lists the 571-L instructions as a separate document. It lists other business property forms under their own titles, such as APP-144 and APP-149. Use the form that matches your purpose, and call the Assessor's Office at 909.387.8307 or toll free at 1.877.885.7654 if you are unsure.
When to file APP-004
Submit APP-004 when you need the Assessor's Office to send you a 571-L Business Property Statement and to give you an account number and BIN for a business. The form asks for the start date of the business at the location, which suggests a new or relocated business. It prints no due date and sets no filing window of its own. For timing questions, call the Assessor's Office at 909.387.8307 or toll free at 1.877.885.7654.
How to fill out APP-004
Enter the Assessor's Parcel Number
Write the Assessor's Parcel Number of the property where the business is located in the first box.
Give the location of the property
In Location of Property, enter the address or location where the business operates.
Enter owner and business names
Write the Business Owner Name. In Doing Business As, enter the name the business operates under.
Provide the main mailing address
Enter the address in Mailing Address (all forms and tax bills will go to this address). Use an address where you want all forms and tax bills sent.
Describe the business
Enter the Type of Business and the Start Date of Business at this Location.
Add a separate request address if needed
Complete Mailing Address for this Property Statement Request only if it differs from the main mailing address. Otherwise leave it blank.
Complete the contact block
Print the contact person's name and title, then enter the daytime phone number, the date and the email address.
Review and download the PDF
Check each box against your records, then download or print the completed PDF from FillingPDF and send it as described under How to submit.
How to submit APP-004
The form lists three ways to send the completed APP-004 to the San Bernardino County Assessor's Office: fax, mail and email.
- Fax: send it to (909) 386-8722.
- Mail: send it to the San Bernardino County Assessor's Office. The form's header gives the office address as 222 W. Hospitality Lane, 4th Floor, San Bernardino, CA 92415-0311.
- Email: send it to [email protected].
Questions can go to the office at 909.387.8307 or toll free at 1.877.885.7654; the county's website is arc.sbcounty.gov. The form names no fee, no required attachment and no in-person option. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Leaving out the Assessor's Parcel Number or the location of the property, which identify the property the request is about.
- Entering a mailing address you do not want used for everything: the form says all forms and tax bills will go to the address in the main mailing address box.
- Filling in the second mailing address box when it matches the first; it is for the property statement request only if the address is different.
- Omitting the start date of the business at this location.
- Leaving out the contact name, title, daytime phone number, date or email, which the form asks for in case the office has questions.
- Sending the request to an address or number other than the fax, mail and email channels printed on the form.
- Using APP-004 to report a change to existing business property, which the county's forms page lists under a separate form, APP-149.
Frequently asked questions
What is APP-004 used for?
APP-004 is the San Bernardino County Assessor-Recorder-County Clerk form for requesting a 571-L Business Property Statement and an account number and BIN. It identifies the property, the business owner, the type of business and a contact person.
How do I submit APP-004 to the San Bernardino County Assessor?
The form lists three channels: fax it to (909) 386-8722, mail it to the San Bernardino County Assessor's Office, or email it to [email protected]. The header gives the office address as 222 W. Hospitality Lane, 4th Floor, San Bernardino, CA 92415-0311.
Can I fill out APP-004 online?
Yes, you can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not send the form to the county; you submit it by fax, mail or email.
Where does the Assessor send my mail after I submit APP-004?
To the address in the main mailing address box: the form says all forms and tax bills will go there. A second box is for the property statement request only if that address is different.
Is there a deadline to file APP-004?
The form prints no due date. It asks for the start date of the business at the location, so it is used when a business needs the statement, account number and BIN. Call the Assessor's Office at 909.387.8307 for timing questions.
What information do I need to complete APP-004?
You need the Assessor's Parcel Number, the location of the property, the owner name, any doing-business-as name, the mailing address, the type of business and its start date at the location. The form also asks for a contact's name, title, daytime phone, date and email.
Does APP-004 require any attachments?
The form lists no attachments. It asks you to complete it and then fax, mail or email it to the Assessor's Office.
Where can I find instructions for the 571-L statement?
The county's forms page at arc.sbcounty.gov/forms-fees/ lists 2026 BOE-571-L Instructions under the Assessor. APP-004 only requests the statement and the account number and BIN.
Ready to fill out APP-004?
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