Fillable PLEASE COMPLETE ONLY THE SECTIONS THAT APPLY AND (California)

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PLEASE COMPLETE ONLY THE SECTIONS THAT APPLY AND (California)

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HCD RT 476.6G Side 1 (Rev. 08/20)
State of California
Department of Housing and Community Development
Division of Codes and Standards
Registration and Titling Program
P.O. Box 277820, Sacramento, CA 95827-7820
(800) 952-8356
www.hcd.ca.gov
MULTI-PURPOSE TRANSFER FORM
PLEASE COMPLETE ONLY THE SECTIONS THAT APPLY AND SIGN BOTTOM OF FORM
UNIT
DESCRIPTION
Decal (License) No.(s): Serial No.(s):
SMOKE DETECTOR AND CARBON MONOXIDE CERTIFICATION
I/We, the undersigned, hereby state that the manufactured home, mobilehome, or multifamily manufactured home described
above is equipped with a properly working, operable smoke detector in accordance with California Health and Safety Code
Section 18029.6 and a carbon monoxide detector in accordance to California Residential Code Section R315.
YES
NO
PARK PURCHASE FEE EXEMPTION
The registered owner of the above-described manufactured home/mobilehome that is located on private property owned by
the registered owner is exempt from payment of the $5 Park Purchase Fund (PPF) fee (Health and Safety Code Section
18114.1). If you feel you qualify for the exemption, complete the following questions:
•
Do you (the registered owner) own your manufactured home/mobilehome? YES NO
•
Do you (the registered owner) own the land your manufactured home/mobilehome is located on? YES NO
DESIGNATION OF CO-OWNER
TERM
We request the Department of Housing and Community Development to register our ownership interest in the unit
described above with the following co-owner term: (READ CAREFULLY AND CHECK ONE BOX.)
JTRS (Joint Tenants with Right of Survivorship): Upon the death of a joint tenant, the interest of the deceased
party passes to the surviving joint tenant. The signature of each joint tenant is required to transfer or encumber the
title.
TENCOM AND (Tenants in Common with the names joined by the word AND): Each tenant in common may
transfer his or her individual interest without the signature of the other tenant(s) in common. The signature of each
tenant in common is required to transfer full interest in the unit to a new registered owner or to encumber the title.
TENCOM OR (Tenants in Common with the names joined by the word OR): Any one of the tenants in common
may transfer full ownership interest in the unit to a new registered owner without the signature of the other tenant(s)
in common. The signature of each tenant in c
ommon is required to encumber the title.
COMPRO (Community Property): A unit may be registered as community property in the names of a husband
and wife. The signature of each spouse is required to transfer full interest in the unit or encumber the title.
COMPRORS (Community Property w
ith Right of Survivorship): A unit may be registered as community
property in the names of a husband and wife. At the death of one spouse, the decedent’s community property
interest passes to the surviving spouse without administration. The signature of each spouse is required to transfer
full interest in the unit or encumber the tit
le.
I/We further agree to indemnify and save harmless the Director of the State of California, Department of Housing and Community
Development, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above described
unit in California, or from, issuance of a California Certificate of Title covering the same.
I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on at
Date City State
Signature Signature
Signature Signature
PHONE #: E-MAIL ADDRESS:
HCD RT 476.6G Side 2 (Rev. 08/20)
Decal (License) No.(s): Serial No.(s):
DECLARATION OF INSTALLATION OF WATER HEATER SEISMIC BRACING
I/We the undersigned hereby state that all fuel gas-burning water heater appliances in the manufactured home, mobilehome,
or multifamily manufactured housing described above are seismically braced, anchored, or strapped in accordance with
Health and Safety Code Section 18031.7 and Part 5 of Title 24 of the California Code of Regulations.
YES
NO
Electric water heater is installed per
manufacturer’s instructions.
SIGNATURE ON FRONT SIDE IS CERTIFICATION FOR THIS SECTION
REASON
FOR
USE TAX AND/OR MOBILEHOME RECOVERY FUND FEE
EXEMPTIO
N
Check appropriate box(es):
The above-described unit was a gift. All rights and interest of ownership were transferred without exchange or money or other
valuable consideration.
The above-described unit has been acquired
from:
parents
,
spouse, grandparent(s), grandchild, child, brother(s)*
*NOTE: A sale between brother(s) or sister(s) is subject to use tax unless both are minors. If minors, check here:
, sister(s)
*
The name of a is being ADDED DELETED to the record.
show relationship
The above-described unit was received as the result of an inheritance.
Transfer of the above-described unit is being made pursuant to a court order.
The transfer of the unit is being made to a revocable trust which (1) the seller has an unrestricted power to revoke the trust, (2) the
transfer does not result in any change in the beneficial ownership of the property, (3) the trust provides that upon revocation of the
trust the property will revert wholly to the seller, and (4) the only consideration for the transfer is the assumption by the trust of an
existing loan for which the tangible personal property being transferred is the sole collateral for the assumed loan.
SIGNATURE ON FRONT SIDE IS CERTIFICATION FOR THIS SECTION
DESIGNATION OF TRUST
I/We, the undersigned trustee(s), hereby state that the unit described above has been placed into a trust. This Declaration of
Trust is dated .
In compliance with Section 18080.1(b) of the California Health and Safety Code, I/we as trustee(s) hereby request the unit described
above be registered as shown below. I/We acknowledge that the Department’s permanent title record and the titling documents for the
unit will reflect the information as shown below.
Print Name of the Trust. This is how the name of the Trust will appear on title.
I/We as trustee(s) agree(s) to notify and make application with the Department of Housing and Community Development to
appropriately amend the permanent registration and titling record immediately upon any change to the original trust agreement
described herein by submitting this form along with all appropriate documents, fees or any other needed items to the Department.
I/We as trustee(s) further agree(s) to indemnify and save harmless the Director of the Department of Housing and Community
Development, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above described
unit in California and from issuance of a California Certificate of Title covering the same.
I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on at
Date City State
Trustee Signature(s):
Street Address or P.O. Box City State
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PLEASE COMPLETE ONLY THE SECTIONS THAT APPLY AND (California)

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Completed 16 June 2022

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