San Bernardino County Office of the Assessor

Please provide the following:
Assessor's Parcel Number:

Mailing Address:
	Name:
	Address:
	City:
	State:
	Zip:

Property (Situs) Address:
Property address is same as mailing address:		Same as above
	Address:
	City:
Daytime Phone (999) 999-9999:		Ext.
Email Address:

Your Opinion of Value as of January 1:
Current Assessment as of January 1:
Your Purchase Price:
Date of Purchase (mm/dd/yy):
Is property income producing? (Yes or No)