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BOE-267-FIR REV. 1 8-05 WELFARE EXEMPTION ASSESSOR S FIELD INSPECTION REPORT Information for Property No. REGULAR ASSESSMENT SUPPLEMENTAL ASSESSMENT Year Name of organization Address of this property Owner only Operator only street city zip code Owner-Operator Date of last inspection of property If claimant is owner name of operator is A. Claimant is primarily check only one 1. religious 2. hospital 3. scientific 4. charitable 5. other explain B. Use of property 1. The primary activity the property is used for is check only one a* administration e. fraternal and lodge meetings i. medical not hospital b. commercial f* fund raising j. recreational c* educational k. rehabilitation d. farming h. housing l* informational 2. Other activities the property is used for are b. a* List letters used in B1 3. All or part write in all or part where applicable of the property is b. vacant or unused c* in excess of that reasonably necessary house personnel whose presence is not institutionally necessary C. Operation of property for benefit of persons P M No Yes Did owner file an exemption claim Recorded 2. In your opinion do operations enhance anyone s private gain If answer is yes explain d. used to E L a* leased or rented If answer is no explain A S D. Ownership of real property as of applicable lien date is recorded in exact name of claimant E* Supplemental Assessment in claimant s name 1. Date of change in ownership Ownership in name of claimant 2. Date of completion of new construction Explain what was constructed 3. Date put to exempt use If only a portion of the property is put to an exempt use describe exempt and nonexempt portions in detail 4. Notice date mailed Not mailed 5. Date claim for exemption from Supplemental Assessment was filed with Assessor 6. Date first installment of supplemental tax bill becomes became delinquent F* A claim for welfare exemption on this property 1. was filed last year 3. was not filed last year but claimed on another property located at all part. give complete address including zip code 2. Denial G* Recommendation 1. Approval 2. is new this year Reason for denial if partial denial identify specific area to be denied Date Inspection for Assessor By Designee. Claimant is primarily check only one 1. religious 2. hospital 3. scientific 4. charitable 5. other explain B. Use of property 1. The primary activity the property is used for is check only one a* administration e. Use of property 1. The primary activity the property is used for is check only one a* administration e. fraternal and lodge meetings i. medical not hospital b. commercial f* fund raising j. recreational c* educational k. fraternal and lodge meetings i. medical not hospital b. commercial f* fund raising j. recreational c* educational k. rehabilitation d. farming h. housing l* informational 2. Other activities the property is used for are b. rehabilitation d. farming h. housing l* informational 2. Other activities the property is used for are b. a* List letters used in B1 3. All or part write in all or part where applicable of the property is b.