SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE
SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE
MAILING ADDRESS
( )
ASSESSOR’S PARCEL NUMBER
PROPERTY ADDRESS CITY
RECORDER’S DOCUMENT NUMBER DATE OF PURCHASE OR TRANSFER
PROBATE NUMBER (if applicable) DATE OF DEATH (if applicable) DATE OF DECREE OF DISTRIBUTION (if applicable)
1. Print full name(s) of transferor(s)
2. Social security number(s)
3. Family relationship(s) to transferee(s)
If adopted, age at time of adoption
4. Was this property the transferor’s principal residence?
Yes No
If yes, please check which of the following exemptions was granted or was eligible to be granted on this property:
Homeowners’ Exemption Disabled Veterans’ Exemption
5. Havetherebeenothertransfersthatqualiedforthisexclusion?
Yes No
If yes,pleaseattachalistofallprevioustransfersthatqualiedforthisexclusion.(Thislistshouldincludeforeachproperty:theCounty,
Assessor’s parcel number, address, date of transfer, names of all the transferees/buyers, and family relationship. Transferor’s principal
residencemustbeidentied.)
6. Was only a partial interest in the property transferred?
Yes No If yes, percentage transferred %
7. Was this property owned in joint tenancy?
Yes No
DAYTIME PHONE NUMBER
CITY, STATE, ZIP EMAIL ADDRESS
DATE
DATE
t
t
BOE-58-AH (P1) REV. 18 (06-17)
CLAIM FOR REASSESSMENT EXCLUSION FOR
TRANSFER BETWEEN PARENT AND CHILD
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address.)
A. PROPERTY
The disclosure of social security numbers is mandatory as required by Revenue and Taxation Code section 63.1. [See Title 42 United
States Code, section 405(c)(2)(C)(i) which authorizes the use of social security numbers for identication purposes in the administration of any
tax.] A foreign national who cannot obtain a social security number may provide a tax identication number issued by the Internal Revenue
Service. The numbers are used by the Assessor and the state to monitor the exclusion limit.
B. TRANSFEROR(S)/SELLER(S) (additional transferors please complete “C” on the reverse)
8.
If the transfer was through the medium of a will and/or trust, you must attach a full and complete copy of the will and/or trust and all
amendments.
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any
accompanying statements or documents, is true and correct to the best of my knowledge and that I am the parent or child (or transferor’s legal
representative) of the transferees listed in Section C. I knowingly am granting this exclusion and will not file a claim to transfer the base year value
of my principal residence under Revenue and Taxation Code section 69.5.
(Please complete applicable information on reverse side.)
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
PRINTED NAME
PRINTED NAME