BOE-58-G (P2) REV. 16 (05-19)
C. TRANSFEREE(S) / BUYER(S) (GRANDCHILD) (additional transferees please complete “C” below)
1. Print full name(s) of transferee(s)
Family relationship(s) to transferor(s)
If adopted, age at time of adoption Adopted by whom?
2. Parent: Name of direct descendent of grandparent (son or daughter)
Date of death of direct descendent
(Direct descendent must be deceased in order to qualify for this exclusion. Please provide death certicate.)
Social security number of direct descendent:
a. Was deceased parent married or in a registered domestic partnership (registered means registered with the California Secretary of
State) as of the date of death? Yes No
b. Is the spouse or registered domestic partner of the deceased parent a (check one):
Parent of the grandchild (go to question c).
Stepparent of the grandchild (a stepparent to the grandchild need not be deceased in meeting the condition that “all of the parents”
of the grandchild must be deceased) (go to question 3).
c. Had surviving spouse/partner remarried or entered into a registered domestic partnership as of the date of purchase or transfer?
Yes No
If yes, date of marriage or registration of the domestic partnership must have occurred prior to the date of purchase or transfer to qualify
for exclusion. Date of marriage/partnership registration:
(Please provide marriage or partnership
certicate.)
If no, surviving spouse/partner is still considered a child of grandparents and must also be deceased prior to the purchase or transfer
to qualify for exclusion. Date of death
(Please provide death certicate.)
3. Did transferee receive a principal residence from parents? (If transferee has already received an excludable principal residence, or interest
therein, from parents, then the purchase or transfer of a principal residence from grandparents will not be excluded as a principal residence
but will be applied toward the one million dollar ($1,000,000) full cash value limit exclusion of other real property received from parents.)
Yes No
If yes: County:
Assessor’s Parcel Number:
4. Did transferee receive real property other than a principal residence from deceased parent who is a direct descendent of
grandparents? (If transferee has already received an excludable principal residence, or interest therein, from parents, then the purchase or
transfer of a principal residence from grandparents will not be excluded as a principal residence but will be applied toward the one million
dollar ($1,000,000) full cash value limit exclusion of other real property received from deceased parents.) Yes No
If yes, attach list of all previous transfers (include for each property: the county, Assessor’s parcel number, situs address, date of transfer,
names of all transferees, and the family relationship).
Note: The Assessor may require additional legal documentation to support the above answers.
ADDITIONAL TRANSFEREE(S)/BUYER(S) (GRANDCHILD) (continued)
NAME RELATIONSHIP
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and any accompanying statements are
true and correct to the best of my knowledge and that I am the grandchild (or their legal representative) of the transferors listed in Section B. I
certify that all my parents who qualify as children of my transferor grandparents are deceased as of the date of transfer or purchase, and that all
of the transferees are eligible transferees within the meaning of section 63.1 of the Revenue and Taxation Code.
t
SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVE DATE
MAILING ADDRESS DAYTIME PHONE NUMBER
(
CITY, STATE, ZIP EMAIL ADDRESS
)
