This government document is issued by Assessor for use in Riverside County, CA
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https://www.asrclkrec.com/media/Forms/Assessor/Exemption_and_Exclusion_Forms/Prop%2019%20-%20Claim%20of%20Persons%20at%20Least%2055%20Years%20of%20Age%20for%20Transfer%20of%20Base%20Year%20Value%20to%20Replacement%20Primary%20Residence%20-%20BOE19B.pdf