STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY
MAIL PROPERTY TAX INFORMATION TO (NAME)
SELLER/TRANSFEROR ASSESSOR'S PARCEL NUMBER
BUYER/TRANSFEREE
ADDRESS
CITY STATE ZIP CODE
BUYER’S DAYTIME TELEPHONE NUMBER
( )
This property is intended as my principal residence. If YES, please indicate the date of occupancy
MO DAY YEAR
YES NO
or intended occupancy.
YES
YES
the transferor, and/or the transferor's spouse registe
creator/grantor/trustor and/or grantor's/trustor
’s spouse
E. This transaction is to replace a principal residence by a person who is severely disabled as dened by Revenue and Taxation Code
section 69.5. Within the same county?
D. This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county?
YES NO
A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
B. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition or removal of
a partner, death of a partner, termination settlement, etc.).
M. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
N. This transfer is to the rst purchaser of a new building containing an active solar energy system.
G. The recorded document creates, terminates, or reconveys a lender's interest in the property.
I. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
F. This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage).
If YES, please explain:
H. This transaction is recorded only as a requirement for nancing purposes or to create, terminate, or reconvey a security interest
(e.g., cosigner). If YES, please explain:
C. This is a transfer between:
1. to/from a revocable trust that may be revoked by the transferor and is for the benet of
2. to/from a trust that may be revoked by the creator/grantor/trustor who is also a joint tenant, and which
names the other joint tenant(s) as beneciaries when the creator/grantor/trustor dies.
3. to/from an irrevocable trust for the benet of the
4. to/from an irrevocable trust from which the property reverts to the creator/grantor/trustor within 12 years.
K. This property is subject to a lease with a remaining lease term of 35 years or more including written options.
J. This is a transfer of property:
*
*
*
*
L. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel
being transferred remain exactly the same after the transfer.
BOE-502-A (P1) REV. 11 (07-10)
NO
NO
parent(s) and child(ren) grandparent(s) and grandchild(ren).
red domestic partner.
PRELIMINARY CHANGE OF OWNERSHIP REPORT
To be completed by the transferee (buyer) prior to a transfer of subject property, in
accordance with section 480.3 of the Revenue and Taxation Code. A Preliminary
Change of Ownership Report must be led with each conveyance in the County
Recorder’s ofce for the county where the property is located. Please answer all
questions in each section, and sign and complete the certication before ling. This
form may be used in all 58 California counties. If a document evidencing a change in
ownership is presented to the Recorder for recordation without the concurrent ling of
a Preliminary Change of Ownership Report, the Recorder may charge an additional
recording fee of twenty dollars ($20).
NOTICE: The property which you acquired may be subject to a supplemental
assessment in an amount to be determined by the County Assessor. Supplemental
assessments are not paid by the title or escrow company at close of escrow, and are
not included in lender impound accounts. You may be responsible for the current or
upcoming property taxes even if you do not receive the tax bill.
PART 1. TRANSFER INFORMATION Please complete all statements.
* If you checked YES to statements C, D, or E, you may qualify for a property tax reassessment exclusion, which may allow you to
maintain your previous tax base. If you checked YES to statement N, you may qualify for a property tax new construction exclusion. A
claim form must be led and all requirements met in order to obtain any of these exclusions. Contact the Assessor for claim forms.
Please provide any other information that will help the Assessor understand the nature of the transfer.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
grantor’s/trustor’s registered domestic partner.
$
PART 3. PURCHASE PRICE AND TERMS OF SALE
Check and complete as applicable.
PART 2. OTHER TRANSFER INFORMATION
Check and complete as applicable.
BOE-502-A (P2) REV. 11 (07-10)
Phone number:
Loan carried by seller Assumption of Contractual Assessment* with a remaining balance of:
* An assessment used to nance property-specic improvements that constitutes a lien against the real property.
. The property was purchased:
. Please
explain any special terms, seller concessions, nancing, and any other information (e.g., buyer assumed the existing loan balance) that
would assist the Assessor in the valuation of your property.
Other. Please explain:
$
Through real estate broker. Broker name:
Direct from seller From a family member
( )
Please explain:
%
Remaining term in years (including written options):
Purchase Foreclosure Gift Trade or exchange Merger, stock, or partnership acquisition (Form BOE-100-B)
Contract of sale. Date of contract: Inheritance. Date of death:
Sale/leaseback Creation of a lease Assignment of a lease Termination of a lease. Date lease began:
Original term in years (including written options):
Other.
:
Interest rate:
$
$
:
Lease/rent
Contract
Mineral rights Other:
YES NO
YES
YES NO
YES N
YES NO
A. Date of transfer, if other than recording date
C. Only a partial interest in the property was transferred.
B. Type of transfer:
A. Total purchase or acquisition price. Do not include closing costs or mortgage insurance.
Down payment: Seller-paid points or closing costs:
Balloon payment:
B
C
$
A. Type of property transferred
B
C
D.
E.
O
O
If YES, enter the value of the personal/business property:
If YES, enter the value attributed to the manufactured home:
If YES, the income is from
Personal/business property, or incentives, are included in the purchase price. Examples are furniture, farm equipment,
machinery, club memberships, etc. Attach list if available.
A manufactured home is included in the purchase price.
The manufactured home is subject to local property tax. If NO, enter decal number:
The property produces rental or other income.
The condition of the property at the time of sale was:
SIGNATURE OF BUYER/TRANSFEREE OR CORPORATE OFFICER
NAME OF BUYER/TRANSFEREE/LEGAL REPRESENTATIVE/CORPORATE OFFICER (PLEASE PRINT)
E-MAIL ADDRESS
DATE
TITLE
t
N
Good Average Fair Poor
If YES, indicate the percentage transferred:
$
%
PART 4. PROPERTY INFORMATION
Check and complete as applicable.
Single-family residence
Co-op/Own-your-own
Manufactured home
Multiple-family residence. Number of units:
Condominium
Unimproved lot
Other. Description: (i.e., timber, mineral, water rights, etc.) Timeshare Commercial/Industrial
.
.
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 belief. This declaration is binding on each and
every buyer/transferee.
The Assessor’s ofce may contact you for additional information regarding this transaction.
$
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