THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION

BOE-267-L1 (P1) REV. 13 (12-17) WELFARE EXEMPTION SUPPLEMENTAL AFFIDAVIT, LOW- HOUSING PROPERTY OF LIMITED PARTNERSHIP This Claim is Filed for Fiscal Year 20 20 This is a Supplemenal Affidavi filed wih BOE-267, Claim for Welfare Exempion (Firs Filing) BOE-267-A, Claim for Welfare Exempion (Annual Filing) If filed wih BOE-267-A, check applicable boxes below Secreary of Sae Form LP-2 filed wihin he las year Limied Parnership Agreemen, or oher agreemen, amended wihin he las year Humbold Couny Assessor 825 5h Sree, Room 300 Eureka, CA 95501-1155 Phone (707) 445-7663 Toll Free (866) 240-0485 Secion 1. Idenificaion of Limied Parnership (LP) and Propery Name of Limied Parnership Propery Locaion (number and sree) Dae Propery Acquired by LP Ciy, Couny, Sae, Zip Code Supplemenal Clearance Cerificae (SCC) No. (Provide copy of cerificae wih his claim and a copy of he Finding Shee issued by he Sae Board of Equalizaion (Board) if filing wih BOE-267. If you do no have an SCC, have you filed a claim for an SCC? Yes No If no, see insrucions for informaion on obaining an SCC claim form Secion 2. Idenificaion of Managing General Parner (MGP) Name of Organizaion Corporae ID No. (or LLC No.) Mailing address (number and sree) Dae Admied ino LP as GP Ciy, Sae, Zip Code Secion 3. Governmen Financing or Tax Credis; Use Resricion As o he low-income housing propery for which his claim is made, he general parners of he limied parnership, including he managing general parner, cerify ha (check all applicable boxes): A. There is an enforceable and verifiable agreemen wih a public agency or a recorded deed resricion ha resrics he projecs s usage and ha provides ha he unis designaed for use by lower-income households are coninuously available o or occupied by lower-income households a rens ha do no exceed hose prescribed by secion 50053 of he Healh and Safey Code, or, o he exen ha he erms of federal, sae, or local financing or financial assisance conflics wih secion 50053, rens ha do no exceed hose prescribed by he erms of he financing or financial assisance. For propery ax exempion purposes, a uni is considered occupied by a lower income household if he occupans were qualified when heir occupancy began, as long as he household income is no above 140% of area median income ( over-income enans), he uni is ren resriced, and he propery receives federal low-income housing ax credis. See Revenue and Taxaion Code secion 214(g)(2)(A)((iii). If you are filing his supplemenal affidavi wih BOE-267 (Firs Filing), submi a copy of he regulaory agreemen or recorded deed resricion. B. The funds which would have been necessary o pay propery axes are used o mainain he affordabiliy of, reduce rens oherwise necessary for, he unis occupied by lower-income households. C. A leas one of he following crieria is applicable (check one): (1) The acquisiion, consrucion, rehabiliaion, developmen, or operaion of he propery is financed wih governmen financing in he form of ax-exemp morgage revenue bonds; general obligaion bonds; local, sae, or federal loans or grans; or any loan insured, held, or guaraneed by he federal governmen; or projec based federal funding under secion 8 of he Housing Ac of 1937. (The erm governmen financing does no include federal renal assisance hrough enan ren-subsidy vouchers under secion 8 of he Housing Ac of 1937.) (2) The owner is eligible for and receives sae low-income housing ax credis pursuan o Revenue and Taxaion secions 12205, 12206, 17057.5, 17058, 23610.4, and 23610.5 or federal low-income housing ax credis pursuan o secion 42 of he Inernal Revenue Code. THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION

BOE-267-L1 (P2) REV. 13 (12-17) Secion 4. Household Informaion A1. Eligibiliy Based on Family Household Income - Lower Income Households Secion 214(g) of he California Revenue and Taxaion Code provides ha low-income housing propery owned and operaed by a limied parnership wih a nonprofi corporaion or eligible limied liabiliy company as managing general parner can qualify for he Welfare Exempion from propery axes o he exen ha he income of he households residing herein do no exceed amouns lised below: (See Secion 4.A2 for income limi excepion) 1 3 5 7 2 4 6 8 A2. Eligibiliy Based on Family Household Income - 140% of Area Median Income (AMI) Secion 214(g)(2)(A)(iii) of he Revenue and Taxaion Code provides ha under cerain circumsances, propery eligible for and receives federal low income housing ax credis (LIHTC) pursuan o Secion 42 of he Inernal Revenue Code can qualify for he welfare exempion from propery axes o he exen ha he income of he households residing herein do no exceed amouns lised below: If you have unis meeing he crieria in A2, ha do no mee he crieria of A1 upon which you seek exempion, check here o confirm he propery has federal LIHTC and submi BOE-267-L3, Welfare Exempion Supplemenal Affidavi, Households Exceeding Low-Income Limis - Over-Income Tenan Daa (). BOE-267-L3 is confidenial. 1 3 5 7 2 4 6 8 Noe: If a dollar amoun is no enered for each number of persons, conac he Couny Assessor for he figures. The amouns are differen for each couny and change annually. In order o qualify all or a porion of he propery for he exempion, you mus have: (1) a signed saemen for each household ha qualifies (you should keep he saemen for fuure audis); and (2) you mus complee pars 4B, 4C, and Secion 5 below. B. Lis of Qualified Households Aach lis showing desired informaion for only hose households ha qualify. Idenify which unis qualify under he crieria indicaed in Secion 4.A2. Also, please idenify he vacan unis reserved for low-income households. Provide he following informaion: address/uni number, number of persons in household, maximum income for household. C. Number of Unis Serving Lower Income Households Noe: Under secion 214(g), he exempion percenage is he oal number of "unis serving lower income households" divided by he oal number of residenial unis. This percenage is applied o he enire propery including "relaed faciliies". 1. Number of residenial unis designaed for use by or serving lower income households - lower income limis. 2. Number of residenial unis occupied by households exceeding lower income limis bu do no exceed ( over-income enans), as repored on BOE-267-L3. 3. Toal number of qualified households (C1 + C2) 4. Toal number of residenial unis in propery. 5. Percenage which he number of "unis serving lower income households" is of he oal number of residenial unis. (C3 / C4 above) EXAMPLE ACTUAL 88 2 90 100 90% (90/100) 5. Propery Use. Does his propery include nonexemp commercial space? Yes No If yes, provide a brief descripion of he nonexemp commercial space:

BOE-267-L1 (P3) REV. 13 (12-17) Secion 6. Managing General Parner Requiremens A. Managing General Parner Designaion. (1) Limied parnership agreemen expressly designaes he nonprofi corporaion as he managing general parner. (2) Managing general parner is auhorized o receive a parnership managemen fee or similar form of compensaion payable in he amoun and manner se forh in he limied parnership agreemen or oher agreemen execued by all of he general parners. (3) Managing general parner has maerial paricipaion in he conrol, managemen and direcion of he limied parnership s business (see Secion 5.B.). (4) Officers and direcors of he for-profi general parners, for-profi limied parners, or any of is for-profi affiliaes, do no, as individuals or collecively, have a conrolling voe or majoriy ineres in he managing general parner. B. Maerial Paricipaion. The managing general parner is a general parner ha has maerial paricipaion in he conrol, managemen, and direcion of he limied parnership s business, in ha he managing general parner has a righ o voe in all he major decisions, including any acions which require a voe of a majoriy in ineres of he general parner; performs subsanial managemen duies (a leas 5 of he 12 duies lised in Secion 5.C.); direcly or indirecly, under is supervision, manages he limied parnership; annually conducs a physical inspecion of he low-income housing propery o ensure ha he propery is being used as low-income housing and mees all of he requiremens of he welfare exempion for low-income housing properies; annually submis a cerificaion o he Couny Assessor of he couny in which he propery is locaed ha he low-income housing propery mees all Welfare Exempion requiremens for low-income housing properies. C. Subsanial Managemen Duies. The managing general parner acually performs a leas 5 of 12 following parnership managemen duies: (1) Managing general parner rens, mainains and repairs he low-income housing propery, or if such duies are delegaed o a propery managemen agen, paricipaes in hiring and overseeing he work of he propery managemen agen. (2) Managing general parner paricipaes in hiring and overseeing he work of all persons necessary o provide services for he managemen and operaion of he limied parnership business. (3) Managing general parner execues and enforces all conracs execued by he limied parnership. (4) Managing general parner execues and delivers all parnership documens on behalf of he limied parnership. (5) Managing general parner prepares or causes o be prepared all repors o be provided o he parners or lenders on a monhly, quarerly, or annual basis consisen wih he requiremens of he limied parnership agreemen. (6) Managing general parner coordinaes all presen and fuure developmen, consrucion, or rehabiliaion of low-income housing propery ha is he subjec of he limied parnership agreemen. (7) Managing general parner moniors compliance wih all governmen regulaions and files or supervises he filing of all required documens wih governmen agencies. (8) Managing general parner acquires, holds, assigns or disposes of propery or any ineres in propery. (9) Managing general parner borrows money on behalf of he limied parnership, encumbers limied parnership asses, places ile in he name of he nominee o obain financing, prepays in whole or in par, refinances, increases, modifies or exends any obligaion. (10) Managing general parner pays organizaional expenses incurred in he creaion of he parnership and all operaional expenses. (11) Managing general parner deermines he amoun and iming of disribuions o parners and esablishes and mainains all required reserves. (12) Managing general parner ensures ha chariable services or benefis, such as vocaional raining, educaion programs, childcare and afer-school programs, culural aciviies, family counseling, ransporaion, meals, and linkages o healh and/or social services are provided or informaion regarding chariable services or benefis are made available o he low-income housing enans. Secion 7. Delegaion of Auhoriy A. The person making his claim cerifies ha he limied parnership agreemen (please check applicable box): Conains a delegaion of auhoriy clause Does no conain a delegaion of auhoriy clause B. If he limied parnership agreemen conains a delegaion of auhoriy clause, such clause provides ha: The managing general parner may no delegae any of is parnership managemen duies, as idenified in Rule 140.1, subdivision (a)(10) and defined in Secion 5 or The managing general parner may delegae is parnership managemen duies, as idenified in Secion 5, o persons who under is supervision, may perform such duies for he parnership subjec o he supervision by he managing general parner. C. The managing general parner has delegaed some or all of is parnership managemen duies idenified in Secion 5 : Yes No If yes, please lis each duy delegaed, he dae delegaed, and he person or eniy performing such duy (aach addiional pages if necessary): THIS STATEMENT IS SUBJECT TO AUDIT

BOE-267-L1 (P4) REV. 13 (12-17) Secion 8. Cerificaion: The form mus be cerified by he managing general parner and all of he general parners of he limied parnership (please aach addiional pages if necessary). CERTIFICATION I cerify (or declare) under penaly of perjury under he laws of he Sae of California ha he foregoing and all informaion conained herein, including any accompanying saemens or documens, is rue, correc, and complee o he bes of my knowledge and belief. NAME OF LIMITED PARTNERSHIP LOCATION OF LIMITED PARTNERSHIP PROPERTY NAME AND TITLE OF MANAGING GENERAL PARTNER (yped or prined) SIGNATURE OF MANAGING GENERAL PARTNER NAME AND TITLE OF GENERAL PARTNER (yped or prined) NAME AND TITLE OF GENERAL PARTNER (yped or prined) NAME AND TITLE OF GENERAL PARTNER (yped or prined) NAME AND TITLE OF GENERAL PARTNER (yped or prined) NAME AND TITLE OF GENERAL PARTNER (yped or prined) NAME AND TITLE OF GENERAL PARTNER (yped or prined) E-MAIL ADDRESS E-MAIL ADDRESS

BOE-267-L1 (P5) REV. 13 (12-17) INSTRUCTIONS FOR FILING WELFARE EXEMPTION SUPPLEMENTAL AFFIDAVIT LOW- HOUSING PROPERTY OF LIMITED PARTNERSHIP FILING OF AFFIDAVIT This affidavi is required under he provisions of secions 214(g), 214.15, 251, and 254.5 of he Revenue and Taxaion Code and mus be filed when seeking exempion on low-income housing propery owned and operaed by a limied parnership. The income of he occupans mus no exceed cerain limis (see secion 4 of he claim form). This affidavi supplemens he claim for Welfare Exempion and mus be filed wih he couny assessor by February 15 o avoid a lae filing penaly under secion 270. If you do no complee and file his form, you may be denied he exempion. The claiman should provide each household living on he propery wih a copy of BOE-267-L-A, Lower Income Households, Family Household Income Reporing Workshee. The organizaion claiming he exempion keeps he compleed, signed saemens in case of furher audi. Do no submi he workshees wih your filing. FISCAL YEAR The fiscal year for which an exempion is sough mus be enered correcly. The proper fiscal year follows he lien dae (12:01 a.m., January 1) as of which he axable or exemp saus of he propery is deermined. For example, a person filing a imely claim in February 2018 would ener 2018-2019 on line four of he claim; a 2017-2018 enry on a claim filed in February 2018 would signify ha a lae claim was being filed for he preceding fiscal year. SECTION 1. Idenificaion of Limied Parnership (LP) and Propery. Idenify he name of he limied parnership ha owns he low-income housing propery, locaion of he low-income housing propery, couny in which he propery is locaed, and dae he propery was acquired by he limied parnership. As a prerequisie o being graned he Welfare Exempion for low-income housing propery owned by a limied parnership, he limied parnership mus qualify for a Supplemenal Clearance Cerificae for Limied Parnership for Low-Income Housing Propery Welfare Exempion (BOE-277-SCC) (hereinafer referred o as SCC ) on he propery. If he limied parnership holds a SCC for he low-income housing propery, idenify he cerificae number or indicae wheher or no an applicaion is pending wih he Board. For addiional informaion regarding he requiremens, see Propery Tax Rules 140, 140.1, and 140.2, available on he Board s websie a www.boe.ca.gov. SECTION 2. Idenificaion of Managing General Parner (MGP). Idenify he name of he managing general parner, corporae idenificaion number or limied liabiliy company number, mailing address of he managing general parner, and he dae he managing general parner was admied o he limied parnership. As a prerequisie o being graned he Welfare Exempion for low-income housing propery owned by a limied parnership, he managing general parner of he limied parnership mus qualify for an Organizaional Clearance Cerificae for Welfare or Veerans Organizaion Exempion (BOE-277-OCC) (hereinafer referred o as OCC ) from he Sae Board of Equalizaion (Board). SECTION 3. Governmen Financing or Tax Credis; Use Resricion. Check all applicable boxes o cerify if (1) he propery use is resriced o low-income housing by a recorded regulaory agreemen or recorded deed resricion, and (2) he funds ha would have been necessary o pay propery axes are used o mainain he affordabiliy of he housing or o reduce he rens for he unis occupied by lower-income households, and (3) he propery receives eiher governmen financing or sae/federal low-income housing ax credis. SECTION 4B. Lis of Qualified Households. Include a lis of all households ha qualify for exempion based on he maximum income level for he couny for he claim year where he propery is locaed (see dollar amouns in Secions 4.A1 and 4.A2). Addiionally, claiman mus submi BOE-267-L3 o include a lis of households ha qualify for exempion under he crieria indicaed in Secion 4.A2. Also, please lis vacan unis held for low-income housing enans. SECTION 4C. Revenue and Taxaion Code secion 214(g)(1) saes renal housing and relaed faciliies are eniled o a parial exempion equal o ha percenage of he value of he propery ha is equal o he percenage ha he number of unis serving lower income households represens of he oal number of residenial unis. The percenage deermined shall apply o he oal value of boh improvemens and land. Idenify he number of unis designaed for use by or serving lower income households and he oal number of residenial unis for he propery. Unis Serving Lower Income Households. Unis serving lower income households shall mean unis ha are occupied by lower income households a an affordable ren, as defined in secion 50053 of he Healh and Safey Code or, o he exen ha he erms of federal, sae, or local financing or financial assisance conflics wih secion 50053, rens ha do no exceed hose prescribed by he erms of he financing or financial assisance. Effecive Ocober 13, 2017, pursuan o Revenue and Taxaion Code secion 214(g)(2)(A)(iii), a uni in a propery ha receives federal low-income housing ax credis shall coninue o be reaed as occupied by a lower income household if he occupans were lower income households on he lien dae in he fiscal year in which heir occupancy of he uni commenced and he uni coninues o be ren resriced, nowihsanding an increase in he income of he occupans of he uni o 140 percen of area median income (AMI), adjused for family size ( over-income enans). Unis reserved for lower income households a an affordable ren ha are emporarily vacan due o enan urnover or repairs shall be couned as occupied.

BOE-267-L1 (P6) REV. 13 (12-17) INSTRUCTIONS FOR FILING WELFARE EXEMPTION SUPPLEMENTAL AFFIDAVIT LOW- HOUSING PROPERTY OF LIMITED PARTNERSHIP Relaed Faciliies. Revenue and Taxaion Code secion 214(g)(3)(B) saes relaed faciliies means any manager s unis and any and all common area spaces ha are included wihin he physical boundaries of he renal housing developmen, including, bu no limied o, common area space, walkways, balconies, paios, clubhouse space, meeing rooms, laundry faciliies, and parking areas, excep any porions of he overall developmen ha are nonexemp commercial space. SECTION 5. This secion requess informaion on any nonexemp commercial space. If applicable, briefly describe he nonexemp commercial space (i.e., muli-sory building wih residenial use on floors 2-5 and reail space on ground floor.) SECTION 6.A. Managing General Parner Designaion. Check all applicable boxes. See Rule 140.1, subdivision (a)(6), which provides he definiion of managing general parner of a limied parnership under Revenue and Taxaion Code secion 214(g). SECTION 6.B. Maerial Paricipaion. A limied parnership, in which he managing general parner is an eligible nonprofi corporaion or a limied liabiliy company, may qualify for exempion for a paricular propery provided ha he limied parnership agreemen, or oher agreemen execued by all of he general parners, provides ha he managing general parner is a general parner ha has maerial paricipaion in he conrol, managemen, and direcion of he limied parnership s business. Check if applicable [see Rule 140.1, subdivision (a)(7)]. SECTION 6.C. Subsanial Managemen Duies. A limied parnership in which he managing general parner is an eligible nonprofi corporaion or limied liabiliy company, may qualify for exempion for a paricular propery provided ha he limied parnership agreemen, or oher agreemen execued by all of he general parners, provides ha he managing general parner is a general parner wih subsanial managemen duies [see Rule 140.1, subdivision (a)(10)]. Check only if 5 of he 12 managemen duies are performed by he managing general parner. SECTION 7. Delegaion of Auhoriy. If he limied parnership agreemen conains a delegaion of auhoriy clause, i may provide eiher ha: (1) he managing general parner may no delegae any of is parnership managemen duies; or (2) he managing general parner may delegae some or all of is parnership managemen duies o persons who, under is supervision, may perform such duies on behalf of he limied parnership [see Rule 140.1, subdivision (d)]. If he managing general parner is auhorized o delegae is parnership duies and elecs o delegae one or more of is duies, he managing general parner mus demonsrae ha i is acually supervising he performance of he delegaed duies. If he agreemen conains a delegaion of auhoriy clause and saes ha he managing general parner may delegae is parnership managemen duies, lis each duy delegaed, he dae each duy was delegaed, and person performing such duy. RECORDS AND DOCUMENTS MUST BE MAINTAINED BY THE MANAGING GENERAL PARTNER A copy of he claim form and supporing documens should be reained by he managing general parner. The managing general parner mus mainain records and documens evidencing he parnership managemen duies performed by he managing general parner. Such records and documens may include, bu are no limied o: accouning books and records; ax reurns; budges and financial repors; repors required by lenders; documens relaed o he consrucion or rehabiliaion of real propery; legal documens such as conracs, deeds, noes, leases, and deeds of rus; documens relaed o complying wih governmen regulaions and filings; documens relaed o propery inspecions; documens relaed o chariable services or benefis provided or he informaion provided regarding such services or benefis; repors prepared for he parners; bank accoun records; audied annual financial saemen of he limied parnership; and propery managemen agreemen.