Fillable CHANGE OF OWNERSHIP STATEMENT (County of Lake)

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CHANGE OF OWNERSHIP STATEMENT (County of Lake)

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BROWSE COUNTY OF LAKE (CA) FORMS

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F. ThistransactionistoreplaceaprincipalresidencebyapersonwhoisseverelydisabledasdenedbyRevenueandTaxationCode
section69.5.Withinthesamecounty?
E.
This transaction is to replace a principal residence owned by a person 55 years of age or older.
Withinthesamecounty?
STREETADDRESSORPHYSICALLOCATIONOFREALPROPERTY
MAIL
PROPERTYTAXINFORMATIONTO(ADDRESS)
SELLER/TRANSFEROR
STATECITY ZIP
CODE
ASSESSOR'SPARCELNUMBER
BUYER’SEMAILADDRESS
YES
YES
YES
NO
NO
NO
A. This
transferissolelybetweenspouses(addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
B. This
transferissolelybetweendomesticpartnerscurrentlyregisteredwiththeCaliforniaSecretaryofState(addition or removal of
a partner, death of a partner, termination settlement, etc.).
N. Thisisatransfersubjecttosubsidizedlow-incomehousingrequirementswithgovernmentallyimposedrestrictions,orrestrictions
imposedbyspecifiednonprofitcorporations.
O. Thistransferistotherstpurchaserofanewbuildingcontaininganactivesolarenergysystem.
H. Therecordeddocumentcreates,terminates,orreconveysalender'sinterestintheproperty.
J. The
recordeddocumentsubstitutesatrusteeofatrust,mortgage,orothersimilardocument.
G.
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).
IfYES,pleaseexplain:
I. This
transactionisrecordedonlyasarequirementfornancingpurposesortocreate,terminate,orreconveyasecurityinterest
(e.g., cosigner).IfYES,pleaseexplain:
C. Thisisatransfer: between parent(s) and child(ren) from grandparent(s) to grandchild(ren).
*
BUYER’SDAYTIMETELEPHONENUMBER
( )
1. to/fromarevocabletrustthatmayberevokedbythetransferorandisforthebenetof
the
transferor,and/orthetransferor'sspouse registereddomesticpartner.
2. to/fromanirrevocabletrustforthebenetofthe
creator/grantor/trustor
and/or grantor's/trustor’sspouse grantor’s/trustor’sregistereddomesticpartner.
L. Thispropertyissubjecttoaleasewitharemainingleasetermof35yearsormoreincludingwrittenoptions.
K. Thisisatransferofproperty:
*
*
*
*
YES NO
Thispropertyisintendedasmyprincipalresidence.IfYES,pleaseindicatethedateofoccupancy
orintendedoccupancy.
MO DAY YEAR
M. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel
beingtransferredremainexactlythesameafterthetransfer.
NAME AND MAILING ADDRESS
(Make necessary corrections in the printed name and mailing address)
D. Thistransferistheresultofacotenant’sdeath.Dateofdeath___________________________
*
YES NO
Areyouadisabledveteranoraunmarriedsurvivingspouseofadisabledveteranwhowas
compensatedat100%bytheDepartmentofVeteransAffairs?
P. Other.Thistransferisto____________________________________________________________
MAILPROPERTYTAXINFORMATIONTO(NAME)
BOE-502-AH (P1) REV. 17 (05-19)
CHANGE OF OWNERSHIP STATEMENT
This statement represents a written request from the Assessor.
Failure to file will result in the assessment of a penalty.
FILE THIS STATEMENT BY:______________________
PART 1. TRANSFER INFORMATION Please complete all statements.
Thissectioncontainspossibleexclusionsfromreassessmentforcertaintypesoftransfers.
PleaserefertotheinstructionsforPart1.
Please provide any other information that will help the Assessor understand the nature of the transfer.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
Remaining term in years (including written options):
BOE-502-AH (P2) REV. 17 (05-19)
PART 2. OTHER TRANSFER INFORMATION
Check and complete as applicable.
A. Dateoftransfer,ifotherthanrecordingdate:
C. Onlyapartialinterestinthepropertywastransferred.
B. Cash
downpaymentorvalueoftradeorexchangeexcludingclosingcosts Amount$_______________
C. First
deedoftrust@______%interestfor______years.Monthlypayment$_____________ Amount$_______________
D. Second
deedoftrust@______%interestfor______years.Monthlypayment$_____________ Amount$_______________
E. Was
anImprovementBondorotherpublicnancingassumedbythebuyer? Outstandingbalance$_______________
If
YES,indicatethepercentagetransferred:
B. Typeoftransfer:
Purchase
Contract
ofsale.Dateofcontract:
Sale/leaseback
Fixed
rate
Fixed
rate
Balloon
payment$_____________
Due
date:_____________
Due
date:_____________
Creation
ofalease
Variable rate
Variable rate
Other.
Pleaseexplain:
Original term in years (including written options):
Assignment of a lease
Loan
carriedbyseller
Loan
carriedbyseller
Bank/Savings
&Loan/CreditUnion
Bank/Savings&Loan/CreditUnion
Inheritance.Dateofdeath:
Termination
ofalease.Dateleasebegan:
Foreclosure Gift Tradeorexchange Merger,stock,orpartnershipacquisition(FormBOE-100-B)
YES NO
%
$
$
A.
Type of property transferred
:
Single-family residence
Lease/rent
Multiple-family
residence.Numberofunits
Co-op/Own-your-own
Contract
Manufactured
home
Condominium
Timeshare Commercial/Industrial
Mineral rights Other:
Unimproved
lot
Other.
Description:(i.e.,timber,mineral,waterrights,etc.)
B.
C.
D.
E.
YES
YES
YES
YES
YES
Good Average Fair Poor
NO
NO
NO
NO
NO
If
YES,enterthevalueofthepersonal/businessproperty:
If
YES,enterthevalueattributedtothemanufacturedhome:
If
YES,theincomeisfrom:
Personal/business
property,orincentives,providedbysellertobuyerareincludedinthepurchaseprice.Examplesofpersonal
propertyarefurniture,farmequipment,machinery,etc.Examplesofincentivesareclubmemberships,etc.Attachlistifavailable.
Amanufacturedhomeisincludedinthepurchaseprice.
The
manufacturedhomeissubjecttolocalpropertytax.IfNO,enterdecalnumber:
Thepropertyproducesrentalorotherincome.
The
conditionofthepropertyatthetimeofsalewas:
Please
describe:__________________________________________________________________________________________________
SIGNATUREOFBUYER/TRANSFEREEORCORPORATEOFFICER
NAMEOFBUYER/TRANSFEREE/PERSONALREPRESENTATIVE/CORPORATEOFFICER(PLEASEPRINT)
TELEPHONE
EMAILADDRESSTITLE
DATE
TheAssessor’sofcemaycontactyouforadditionalinformationregardingthistransaction.
t
Phonenumber:G. Thepropertywaspurchased:
Other.Pleaseexplain:
Throughrealestatebroker.Brokername:
Direct from seller
From a family member-Relationship
( )
H. Pleaseexplainanyspecialterms,sellerconcessions,broker/agentfeeswaived,nancing,andanyotherinformation(e.g.,buyerassumedthe
existingloanbalance)thatwouldassisttheAssessorinthevaluationofyourproperty.
( )
Incentives
$
F. Amount,ifany,ofrealestatecommissionfeespaidbythebuyerwhicharenotincludedinthepurchaseprice $_______________
$_______________
FHA(___DiscountPoints)
Cal-Vet
VA(___DiscountPoints)
Balloonpayment$_____________
PART 3. PURCHASE PRICE AND TERMS OF SALE
Check and complete as applicable.
A. Totalpurchaseprice
PART 4. PROPERTY INFORMATION
Check and complete as applicable.
CERTIFICATION
I certify (or declare) that the foregoing and all information hereon, including any accompanying statements or documents, is true and correct to
the best of my knowledge and belief.
BOE-502-AH (P3) REV. 17 (05-19)
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 file a change in ownership statement with the county recorder or assessor. The change in ownership statement must be filed at the
time of recording or, if the transfer is not recorded, within 90 days of the date of the change in ownership, except that where the change in ownership has
occured by reason of death the statement shall be filed within 150 days after the date of death or, if the estate is probated, shall be filed at the time the
inventory and appraisal is filed. The failure to file a change in ownership statement within 90 days from the date a written request is mailed 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 reflecting the
change in ownership of the real property or manufactured home, whichever is greater, but not to exceed five thousand dollars ($5,000) if the property is
eligible for the homeowners' exemption of twenty thousand dollars ($20,000) if the property is not eligible for the homeowners' exemption if that failure to
file was not willful. The assessor is required to mail the request to file a change in ownership statement to the transferee at the address specified for
mailing tax information on either the recorded instrument, the document evidencing a transfer of an interest in real property or manufactured home, or on
the filed preliminary change in ownership report, or, if an address is not specified for mailing tax information, to any address reasonably known to the
assessor. 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.
ADDITIONALINFORMATION
NAME AND MAILING ADDRESS OF BUYER: Please make necessary corrections to the printed name and mailing address. Enter
Assessor’sParcelNumber,name of seller, buyer’s daytimetelephonenumber,buyer’s email address, and streetaddressorphysical
location of the real property.
NOTE: Your telephone number and/or email address is very important. If there is a question or a problem, the Assessor
needs to be able to contact you.
MAILPROPERTYTAXINFORMATIONTO:Enterthename,address,city,state,andzipcodewherepropertytaxinformationshould
bemailed.Thismustbeavalidmailingaddress.
PRINCIPALRESIDENCE:Tohelpyoudetermineyourprincipalresidence,consider(1)whereyouareregisteredtovote,(2)thehome
address on your automobile registration, and (3) where you normally return after work. If after considering these criteria you are still
uncertain,choosetheplaceatwhichyouhavespentthemajorportionofyourtimethisyear.CheckYESifthepropertyisintendedas
yourprincipalresidence,andindicatethedateofoccupancyorintendedoccupancy.
DISABLED VETERAN: If you checked YES, you may qualify for a property tax exemption. A claim form must be filed and all
requirements met in order to obtain the exemption. Please contact the Assessor for a claim form.
PART 1: TRANSFER INFORMATION
If you check YES to any of these statements, the Assessor may ask for supporting documentation.
C, D, E, F:IfyoucheckedYEStoanyofthesestatements,youmayqualifyforapropertytaxreassessmentexclusion,whichmayallow
youtomaintainyourproperty’sprevioustaxbase. A claim form must be filed and all requirements met in order to obtain any of
these exclusions. ContacttheAssessorforclaimforms.NOTE:Ifyougivesomeonemoneyorpropertyduringyourlife,youmaybe
subjecttofederalgifttax.Youmakeagiftifyougiveproperty(includingmoney),theuseofproperty,ortherighttoreceiveincomefrom
propertywithoutexpectingtoreceivesomethingofatleastequalvalueinreturn.Thetransferor(donor)mayberequiredtofileForm
709,FederalGiftTaxReturn,withtheInternalRevenueServiceiftheymakegiftsinexcessoftheannualexclusionamount.
G:CheckYESifthereasonforrecordingistocorrectanamealreadyontitle[e.g.,MaryJones,whoacquiredtitleasMaryJ.Smith,is
grantingtoMaryJones].Thisisnotforusewhenanameisbeingremovedfromtitle.
H:CheckYESifthechangeinvolvesalender,whoholdstitleforsecuritypurposesonaloan,andwhohasnootherbeneficialinterest
in the property.
"Beneficial interest" is the right to enjoy all the benefits of property ownership. Those benefits include the right to use, sell,
mortgage,orleasethepropertytoanother.Abeneficialinterestcanbeheldbythebeneficiaryofatrust,whilelegalcontrolofthe
trustisheldbythetrustee.
I: A "cosigner"isathirdpartytoamortgage/loanwhoprovidesaguaranteethataloanwillberepaid.Thecosignersigns
anagreement
withthelenderstatingthatiftheborrowerfailstorepaytheloan,thecosignerwillassumelegalliabilityforit.
M:Thisisprimarilyforusewhenthetransferisinto,outof,orbetweenlegalentitiessuchaspartnerships,corporations,orlimitedliability
companies.CheckYESonlyiftheinterestheldineachandeveryparcelbeingtransferredremainsexactly the same.
N: Check YES only if this property is subject to a government or nonprofit affordable housing program that imposes restrictions.
Property may qualify for a restricted valuation (i.e., may result in lower taxes).
O: If you checked YES, you may qualify for a new construction property tax exclusion. A claim form must be filed and all
requirements met in order to obtain the exclusion. Contact the Assessor for a claim form.
PART 2: OTHER TRANSFER INFORMATION
A:Thedateofrecordingisrebuttablypresumedtobethedateoftransfer.Ifyoubelievethedateoftransferwasadifferentdate(e.g.,
thetransferwasbyanunrecordedcontract,oraleaseidentifiesaspecificstartdate),putthedateyoubelieveisthecorrecttransfer
date.Ifitisnotthedateofrecording,theAssessormayaskyouforsupportingdocumentation.
B: Check the box that corresponds to the type of transfer. If OTHER is checked, please provide a detailed description. Attach a
separatesheet if necessary.
C. If this transfer was the result of an inhertiance following the death of the property owner, please complete a Change in
Ownership Statement, Death of Real Property Owner, formBOE-502-D,ifnotalreadyfiledwiththeAssessor’soffice.
“Mortgage insurance”isinsuranceprotectingalenderagainstlossfromamortgagor’sdefault,issuedbytheFHAoraprivate
mortgageinsurer.
B. Entertheamountofthedownpayment,whetherpaidincashorbyanexchange.Ifthroughanexchange,excludetheclosingcosts.
“Closing costs”arefeesandexpenses,overandabovethepriceoftheproperty,incurredbythebuyerand/orseller,which
includetitlesearches,lawyer’sfees,surveycharges,anddocumentrecordingfees.
C. EntertheamountoftheFirstDeedofTrust,ifany.Checkalltheapplicableboxes,andcompletetheinformationrequested.
A “balloon payment”isthenalinstallmentofaloantobepaidinanamountthatisdisproportionatelylargerthantheregular
installment.
D. EntertheamountoftheSecondDeedofTrust,ifany.Checkalltheapplicableboxes,andcompletetheinformationrequested.
E. Iftherewasanassumptionofanimprovementbondorotherpublicnancingwitharemainingbalance,entertheoutstandingbalance,
andmarktheapplicablebox.
An “improvement bond or other public nancing” is a lien against real property due to property-specic improvement
nancing,suchasgreenorsolarconstructionnancing,assessmentdistrictbonds,Mello-Roos(aformofnancingthatcanbe
usedbycities,countiesandspecialdistrictstonancemajorimprovementsandserviceswithintheparticulardistrict)orgeneral
improvementbonds,etc.Amountsforrepaymentofcontractualassessmentsareincludedwiththeannualpropertytaxbill.
F. Entertheamountofanyrealestatecommissionfeespaidbythebuyerwhicharenotincludedinthepurchaseprice.
G. Ifthepropertywaspurchasedthrougharealestatebroker,checkthatboxandenterthebroker’snameandphonenumber.Ifthe
propertywaspurchaseddirectlyfromtheseller(whoisnotafamilymemberofoneofthepartiespurchasingtheproperty),checkthe
“Direct from seller”box.Ifthepropertywaspurchaseddirectlyfromamemberofyourfamily,orafamilymemberofoneofthepartieswho
ispurchasingtheproperty,checkthe“From a family member”boxandindicatetherelationshipofthefamilymember(e.g.,father,aunt,
cousin,etc.).Ifthepropertywaspurchasedbysomeothermeans(e.g.,overtheInternet,atauction,etc.),checkthe“OTHER”boxand
provide a detailed description (attach a separate sheet if necessary).
H. Describeanyspecialterms(e.g.,sellerretainsanunrecordedlifeestateinaportionoftheproperty,etc.),sellerconcessions(e.g.,
seller agrees to replace roof, seller agrees to certain interior nish work, etc.), broker/agent fees waived (e.g., fees waived by the
broker/agentforeitherthebuyerorseller),nancing,buyerpaidcommissions,andanyotherinformationthatwillassisttheAssessorin
determiningthevalueoftheproperty.
PART 4: PROPERTY INFORMATION
A. Indicatethepropertytypeorpropertyrighttransferred.Propertyrightsmayincludewater,timber,mineralrights,etc.
B. CheckYESifpersonal,businesspropertyorincentivesareincludedinthepurchasepriceinPart3.Examplesofpersonalorbusiness
propertyarefurniture,farmequipment,machinery,etc.Examplesofincentivesareclubmemberships(golf,health,etc.),skilifttickets,
homeowners’dues,etc.Attachalistofitemsandtheirpurchasepriceallocation.Anadjustmentwillnotbemadeifadetailedlistisnot
provided.
C. CheckYESifamanufacturedhomeorhomesareincludedinthepurchaseprice.Indicatethepurchasepricedirectlyattributable
toeachofthemanufacturedhomes.IfthemanufacturedhomeisregisteredthroughtheDepartmentofMotorVehiclesinlieuofbeing
subjecttopropertytaxes,checkNOandenterthedecalnumber.
D. CheckYESifthepropertywaspurchasedoracquiredwiththeintenttorentorleaseitouttogenerateincome,andindicatethesource
ofthatanticipatedincome.CheckNOifthepropertywillnotgenerateincome,orwaspurchasedwiththeintentofbeingowner-occupied.
E. Provideyouropinionoftheconditionofthepropertyatthetimeofpurchase.Ifthepropertyisin“fair” or “poor”condition,includea
brief description of repair needed.
BOE-502-AH(P4)REV.17(05-19)
PART 3: PURCHASE PRICE AND TERMS OF SALE
Itisimportanttocompletethissectioncompletelyandaccurately.Thereportedpurchasepriceandtermsofsaleareimportantfactorsin
determiningtheassessedvalueoftheproperty,whichisusedtocalculateyourpropertytaxbill.Yourfailuretoprovideanyrequiredor
requestedinformationmayresultinaninaccurateassessmentofthepropertyandinanoverpaymentorunderpaymentoftaxes.
A. Enterthetotalpurchaseprice,notincludingclosingcostsormortgageinsurance.
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CHANGE OF OWNERSHIP STATEMENT (County of Lake)

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Completed 6 August 2020

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