Homeowners Exemption Termination Notice {ACR 217}

PETER ALDANA COUNTY OF RIVERSIDE ASSESSOR-COUNTY CLERK-RECORDER COUNTY ADMINISTRATIVE CENTER 4080 Lemon Street, 1st Floor P.O. Box 751 Riverside, CA 92502-0751 (951) 955-6200 HOMEOWNERS' EXEMPTION TERMINATION NOTICE ATTENTION: Owner name: Street address: City/State/Zip: Parcel number: Please indicate your new mailing address: Riverside County Assessor Please be advised that the undersigned has vacated the property mentioned above and, accordingly, / is no longer entitled to the Homeowners' Exemption with respect to that property as of / . Month Day Year If the spouse or co-owner occupied the property and is no longer residing there, please enter his/her social security number(s) below. Owner Social Security Number Owner Signature Spouse/Co-Owner Social Security Number Date Spouse/Co-Owner Signature Date ACR 217 (Rev. 09/2006) Available in Alternate Formats American LegalNet, Inc. www.FormsWorkFlow.com