Under the provisions of section 217, Revenue and Taxation Code, certain articles of personal property which have been made available
for display in a publicly owned art gallery or museum, or in a museum regularly open to the public and operated by a nonprofit
organization qualified for exemption under section 23701d of the Revenue and Taxation Code for a minimum period of
90 days during the 12-month period immediately preceding January 1, or for less than 90 days immediately preceding
January 1 but which will be made available for 90 days during the 12-month period commencing with the first day the
property was made available, shall be exempt from taxation.
Nature of the Personal Property for Which Exemption Is Claimed [check the appropriate box(es); additional works of art may be listed on a separate sheet, with nature and description]
Original Painting
Original Mosaic
Original Drawing or Sketches
Original Sculpture
Original Statuary
Work of the Free Fine Arts (check below)
Etching
Engraving
Woodcut
Lithograph
Prints Made by Hand Transfer Process
Other Original Work of the Free Fine Arts
Do the Items Described Above Include Articles of Utility or Articles Designed for Industrial Use?
YesNo
Does Claimant Hold Works of Art Primarily for Purposes of Sale?
YesNo
CERTIFICATION OF CLAIMANT
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon,
including any accompanying statements or documents, is true, correct and complete to the best of my knowledge and belief.
CERTIFICATION OF MUSEUM DIRECTOR OR OFFICER
The work of art described above was made available for display from
, 20
to
, 20
(If additional works are listed on an attachment, the director or officer must sign this certificate and each attachment.)
I certify (or declare) that the information contained herein is true, correct, and complete to the best of my knowledge and belief.
