This form is completed when a person who is a victim of either a wildfire or other natural disaster for which the governor declared a state of emergency wishes to transfer the base year value from a damaged or destroyed residence to a replacement residence. At least one of the transfers must be on or after April 1, 2021.

This claim should be filed when your property has been damaged or destroyed through no fault of your own. Filing this form may lower your property tax assessment until the property is repaired or reconstructed.