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Modoc County Assessor 204 S Court St., Room (Revize)

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BOE-502-D (P1) REV. 12 (02-21)
CHANGE IN OWNERSHIP STATEMENT
DEATH OF REAL PROPERTY OWNER
This notice is a request for a completed Change in
Ownership Statement. Failure to le this statement will
result in the assessment of a penalty.
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address)
Section 480(b) of the Revenue and Taxation Code requires that
the personal representative le this statement with the Assessor
in each county where the decedent owned property at the time of
death. File a separate statement for each parcel of real property
owned by the decedent.
NAME OF DECEDENT DATE OF DEATH
YES NO
Did the decedent have an interest in real property in this county? If YES, answer all questions. If NO, sign and
complete the certication on page 2.
STREET ADDRESS OF REAL PROPERTY CITY ZIP CODE ASSESSOR’S PARCEL NUMBER (APN)*
*If more than 1 parcel, attach separate sheet.
DESCRIPTIVE INFORMATION
R
(IF APN UNKNOWN)
DISPOSITION OF REAL PROPERTY
R
Copy of deed by which decedent acquired title is attached.
Copy of decedent’s most recent tax bill is attached.
Deed or tax bill is not available; legal description is attached.
Succession without a will
Probate Code 13650 distribution
Adavit
Decree of distribution
pursuant to will
Action of trustee pursuant
to terms of a trust
TRANSFER INFORMATION
R
Check all that apply and list details below.
Decedent’s spouse Decedent’s registered domestic partner
Decedent’s child(ren) or parent(s). If qualied for exclusion from reassessment, a Claim for Reassessment Exclusion for Transfer
Between Parent and Child must be led (see instructions). Was this the decendent's principal residence?
YES NO
Decedent’s grandchild(ren). If qualied for exclusion from reassessment, a Claim for Reassessment Exclusion for Transfer
Between Grandparent and Grandchild must be led (see instructions). Was this the decendent's principal residence?
YES NO
Cotenant to cotenant. If qualied for exclusion from reassessment, an Adavit of Cotenant Residency must be led (see
instructions).
Other beneciaries or heirs.
A trust.
NAME OF TRUSTEE ADDRESS OF TRUSTEE
List names and percentage of ownership of all beneciaries or heirs:
NAME OF BENEFICIARY OR HEIRS RELATIONSHIP TO DECEDENT PERCENT OF OWNERSHIP RECEIVED
This property has been or will be sold prior to distribution. (Attach the conveyance document and/or court order).
NOTE: Sale of the property does not relieve the need to le a Claim for Reassessment Exclusion for Transfer Between Parent
and Child if appropriate.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
Modoc County Assessor
204 S Court St., Room 106
Alturas, CA 96101
530.233.6218
BOE-502-D (P2) REV. 12 (02-21)
YES NO
Will the decree of distribution include distribution of an ownership interest in any legal entity that owns real property
in this county? If YES, will the distribution result in any person or legal entity obtaining control of more than 50% of
the ownership of that legal entity? If YES, complete the following section.
YES NO
NAME AND ADDRESS OF LEGAL ENTITY NAME OF PERSON OR ENTITY GAINING SUCH CONTROL
YES NO
Was the decedent the lessor or lessee in a lease that had an original term of 35 years or more, including renewal
options? If YES, provide the names and addresses of all other parties to the lease.
NAME MAILING ADDRESS CITY STATE ZIP CODE
t
MAILING ADDRESS FOR FUTURE PROPERTY TAX STATEMENTS
NAME
ADDRESS CITY STATE ZIP CODE
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the information contained herein is true,
correct and complete to the best of my knowledge and belief.
SIGNATURE OF SPOUSE/REGISTERED DOMESTIC PARTNER/PERSONAL REPRESENTATIVE
PRINTED NAME
TITLE DATE
EMAIL ADDRESS DAYTIME TELEPHONE
( )
INSTRUCTIONS
Failure to le a Change in Ownership Statement within the time prescribed by law may result in a penalty of
either $100 or 10% of the taxes applicable to the new base year value of the real property or manufactured
IMPORTANT
home, whichever is greater, but not to exceed ve thousand dollars ($5,000) if the property is eligible for the
homeowners’ exemption or twenty thousand dollars ($20,000) if the property is not eligible for the homeowners’
exemption 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 subjected to the same penalties for nonpayment.
Section 480 of the Revenue and Taxation Code states, in part:
(a) Whenever there occurs any change in ownership of real property or of a manufactured home that is subject to local property taxation and is assessed
by the county assessor, the transferee shall le a signed change in ownership statement in the county where the real property or manufactured home is
located, as provided for in subdivision (c). In the case of a change in ownership where the transferee is not locally assessed, no change in ownership
statement is required.
(b) The personal representative shall le a change in ownership statement with the county recorder or assessor in each county in which the decedent
owned real property at the time of death that is subject to probate proceedings. The statement shall be led prior to or at the time the inventory and
appraisal is led with the court clerk. In all other cases in which an interest in real property is transferred by reason of death, including a transfer through
the medium of a trust, the change in ownership statement or statements shall be led by the trustee (if the property was held in trust) or the transferee
with the county recorder or assessor in each county in which the decedent owned an interest in real property within 150 days after the date of death.
The above requested information is required by law. Please reference the following:
• Passage of Decedent’s Property: Benecial interest passes to the decedent's heirs eectively on the decedent's date of death. However, a document
must be recorded to vest title in the heirs. An attorney should be consulted to discuss the specic facts of your situation.
• Change in Ownership: California Code of Regulations, Title 18, Rule 462.260(c), states in part that “[i]nheritance (by will or intestate succession)”
shall be "the date of death of decedent."
• Inventory and Appraisal: Probate Code, Section 8800, states in part, "Concurrent with the ling of the inventory and appraisal pursuant to this section,
the personal representative shall also le a certication that the requirements of Section 480 of the Revenue and Taxation Code either:
(1) Are not applicable because the decedent owned no real property in California at the time of death
(2) Have been satised by the ling of a change in ownership statement with the county recorder or assessor of each county in California in which
the decedent owned property at the time of death."
• Parent/Child and Grandparent/Grandchild Exclusions: A claim must be led within three years after the date of death/transfer, but prior to the date
of transfer to a third party; or within six months after the date of mailing of a Notice of Assessed Value Change, issued as a result of the transfer of
property for which the claim is led. An application may be obtained by contacting the county assessor.
• Cotenant to cotenant. An adavit must be led with the county assessor. An adavit may be obtained by contacting the county
assessor. This statement will remain condential as required by Revenue and Taxation Code Section 481, which states in part:
"These statements are not public documents and are not open to inspection, except as provided by Section 408."
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
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Modoc County Assessor 204 S Court St., Room (Revize)

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Completed 16 May 2022

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