E. ThistransactionistoreplaceaprincipalresidencebyapersonwhoisseverelydisabledasdenedbyRevenueandTaxationCode
section69.5.Withinthesamecounty?
D. This transaction is to replace a principal residence by a person 55 years of age or older.
Withinthesamecounty?
STREETADDRESSORPHYSICALLOCATIONOFREALPROPERTY
SELLER/TRANSFEROR
BUYER/TRANSFEREE
MAIL PROPERTY TAX INFORMATION TO (NAME)
ADDRESS
CITY STATE ZIPCODE
ASSESSOR'SPARCELNUMBER
BUYER’S DAYTIME TELEPHONE NUMBER
PART 1. TRANSFER INFORMATION Please complete all statements.
YES
YES NO
NO
A. This
NO
transferissolelybetweenspouses(addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
B. ThistransferissolelybetweendomesticpartnerscurrentlyregisteredwiththeCaliforniaSecretaryofState(addition or removal of
a partner, death of a partner, termination settlement, etc.).
M.Thisisatransfersubjecttosubsidizedlow-incomehousingrequirementswithgovernmentallyimposedrestrictions.
N. Thistransferistotherstpurchaserofanewbuildingcontaininganactivesolarenergysystem.
G.Therecordeddocumentcreates,terminates,orreconveysalender'sinterestintheproperty.
I. Therecordeddocumentsubstitutesatrusteeofatrust,mortgage,orothersimilardocument.
F. This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage).
IfYES,pleaseexplain:
H. Thistransactionisrecordedonlyasarequirementfornancingpurposesortocreate,terminate,orreconveyasecurityinterest
(e.g., cosigner).IfYES,pleaseexplain
::
C. This
isatransferbetween: parent(s) and child(ren)parent(s) and child(ren) arent(s) and grandchild(ren).
*
*
( )
1.to/fromarevocabletrustthatmayberevokedbythetransferorandisforthebenetof
thetransferor,and/orthetransferor'sspouse
registereddomesticpartner.
2. to/fromatrustthatmayberevokedbythecreator/grantor/trustorwhoisalsoajointtenant,andwhich
namestheotherjointtenant(s)asbeneciarieswhenthecreator/grantor/trustordies.
3.to/fromanirrevocabletrustforthebenetofthe
creator/grantor/trustorand/orgrantor's/trustor’sspouse
grantor’s/trustor’sregistereddomesticpartner.
4.
to/fromanirrevocabletrustfromwhichthepropertyrevertstothecreator/grantor/trustorwithin12years.
K. Thispropertyissubjecttoaleasewitharemainingleasetermof35yearsormoreincludingwrittenoptions.
J. This is a transfer of property:
*
YESYES
This
NO
propertyisintendedasmyprincipalresidence.IfYES,pleaseindicatethedateofoccupancy
orintendedoccupancy.
MO DAY YEAR
L. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel
beingtransferredremainexactlythesameafterthetransfer.
grandp
*
BOE-502-AH (P1) REV. 13 (07-10)
CHANGE IN OWNERSHIP STATEMENT
This statement represents a written request from the Assessor.
Failure to le will result in the assessment of a penalty.
FILE THIS STATEMENT BY:
IMPORTANT NOTICE
The law requires any transferee acquiring an interest in real property or manufactured home subject to local property taxation, and that is
assessed by the county assessor, to le a Change in Ownership Statement with the County Recorder or Assessor. The Change in Ownership
Statement must be led at the time of recording or, if the transfer is not recorded, within 45 days of the date of the change in ownership, except
that where the change in ownership has occurred by reason of death the statement shall be led within 150 days after the date of death or, if
the estate is probated, shall be led at the time the inventory and appraisal is led. The failure to le a Change in Ownership Statement within
45 days from the date of a written request by the Assessor results in a penalty of either: (1) one hundred dollars ($100); or (2) 10 percent of the
taxes applicable to the new base year value reecting the change in ownership of the real property or manufactured home, whichever is greater,
but not to exceed two thousand ve hundred dollars ($2,500) if that failure to le was not willful. This penalty will be added to the assessment
roll and shall be collected like any other delinquent property taxes, and be subject to the same penalties for nonpayment.
*Ifyou checkedYES to statementsC, D, orE, you mayqualifyfor a propertytax reassessment exclusion,which may allowyou to
maintainyourprevioustaxbase.IfyoucheckedYEStostatementN,youmayqualifyforapropertytaxnewconstructionexclusion.A
claimformmustbeledandallrequirementsmetinordertoobtainanyoftheseexclusions.ContacttheAssessorforclaimforms.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
PleaseprovideanyotherinformationthatwillhelptheAssessorunderstandthenatureofthetransfer.
YESYES