RECORDING REQUESTED BY
NAME: ___________________________________________________
WHEN RECORDED MAIL TO:
NAME
: _________________________________________________
ADDRESS: _________________________________________________
CITY / STATE / ZIP: ____________________________________________
(DOCUMENT WILL ONLY BE RETURNED TO NAME & ADDRESS IDENTIFIED ABOVE)
(SPACE ABOVE FOR RECORDER’S USE)
Documentary Transfer Tax is $_____________
(TAX MUST BE A GOOD MULTIPLE OF $ 0.55)
( ) computed on full value of property conveyed.
( ) computed on full value less value of liens and encumbrances remaining.
( ) Unincorporated area: ( ) City of: ____________________________________.
City transfer tax is $____________________
(TAX MUST BE A GOOD MULTIPLE OF $ 1.65)
Signature of declarant X ________________________________________________
A P N: _________________________________________
____________________________________________________________________________________
(DOCUMENT TITLE)
MAIL TAX STATEMENT TO:
NAME: __________________________________________________________________________________________
ADDRESS: __________________________________________________________________________________________
CITY / STATE / ZIP ______________________________________________________________________________
SEPARATE PAGE, PURSUANT TO CA. GOV’T. CODE 27361.6
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