ࡱ> kmhij% bjbjJJ ;(xAd(xAdNu''''';;;8so;,8+t%%%%&h'd'4W7Y7Y7Y7Y7Y7Y7$9<}7i'*&&**}7''%%7111*v'%'%W71*W7111% z/+F1C770,81`=u+`=1`='1((r1)\n)K(((}7}771(((,8****`=((((((((( : PRELIMINARY CHANGE OF OWNERSHIP REPORTTo 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 filed with each conveyance in the County Recorders office for the county where the property is located. FOR ASSESSORS USE ONLY ASSESSORS PARCEL NUMBER FORMTEXT      SELLER/TRANSFEROR FORMTEXT      BUYER S DAYTIME TELEPHONE NUMBER( FORMTEXT      ) FORMTEXT      BUYER S EMAIL ADDRESS FORMTEXT      STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY FORMTEXT        FORMCHECKBOX  YES FORMCHECKBOX  NOThis property is intended as my principal residence. If YES, please indicate the date of occupancy or intended occupancy.MODAYYEAR  FORMCHECKBOX  YES FORMCHECKBOX  NOAre you a disabled veteran or a unmarried surviving spouse of a disabled veteran who was compensated at 100% by the Department of Veterans Affairs?MAIL PROPERTY TAX INFORMATION TO (NAME) FORMTEXT      MAIL PROPERTY TAX INFORMATION TO (ADDRESS)CITYSTATEZIP CODE FORMTEXT       FORMTEXT       FORMTEXT     FORMTEXT      PART 1. TRANSFER INFORMATIONPlease complete all statements. This section contains possible exclusions from reassessment for certain types of transfers.YESNO FORMCHECKBOX  FORMCHECKBOX A.This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.). FORMCHECKBOX  FORMCHECKBOX 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.). FORMCHECKBOX  FORMCHECKBOX *C.This is a transfer:  FORMCHECKBOX  between parent(s) and child(ren) FORMCHECKBOX  from grandparent(s) to grandchild(ren). FORMCHECKBOX  FORMCHECKBOX *D.This transfer is the result of a cotenants death. Date of death FORMCHECKBOX  FORMCHECKBOX *E.This transaction is to replace a principal residence by a person 55 years of age or older. Within the same county?  FORMCHECKBOX  YES  FORMCHECKBOX  NO FORMCHECKBOX  FORMCHECKBOX *F.This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code section 69.5. Within the same county?  FORMCHECKBOX  YES  FORMCHECKBOX  NO FORMCHECKBOX  FORMCHECKBOX  G.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: FORMCHECKBOX  FORMCHECKBOX H.The recorded document creates, terminates, or reconveys a lenders interest in the property. FORMCHECKBOX  FORMCHECKBOX  I. This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest(e.g., cosigner). If YES, please explain: FORMCHECKBOX  FORMCHECKBOX J.The recorded document substitutes a trustee of a trust, mortgage, or other similar document.K.This is a transfer of property: FORMCHECKBOX  FORMCHECKBOX 1.to/from a revocable trust that may be revoked by the transferor and is for the benefit of  FORMCHECKBOX  the transferor, and/or  FORMCHECKBOX  the transferors spouse  FORMCHECKBOX  registered domestic partner. FORMCHECKBOX  FORMCHECKBOX 2.to/from an irrevocable trust for the benefit of the  FORMCHECKBOX  creator/grantor/trustor and/or  FORMCHECKBOX  grantors/trustors spouse  FORMCHECKBOX  grantors/trustors registered domestic partner. FORMCHECKBOX  FORMCHECKBOX L.This property is subject to a lease with a remaining lease term of 35 years or more including written options. FORMCHECKBOX  FORMCHECKBOX M.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. FORMCHECKBOX  FORMCHECKBOX N.This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions or restrictions imposed by special nonprofit corporations. FORMCHECKBOX  FORMCHECKBOX  *O.This transfer is to the first purchaser of a new building containing an active solar energy system. FORMCHECKBOX  FORMCHECKBOX P.Other. This transfer is to * Please refer to the instructions for Part 1. Please provide any other information that will help the Assessor understand the nature of the transfer.THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION PART 2. OTHER TRANSFER INFORMATIONCheck and complete as applicable.A.Date of transfer, if other than recording date:B.Type of transfer: FORMCHECKBOX  Purchase  FORMCHECKBOX  Foreclosure  FORMCHECKBOX  Gift  FORMCHECKBOX  Trade or exchange  FORMCHECKBOX  Merger, stock, or partnership acquisition (Form BOE-100-B) FORMCHECKBOX  Contract of sale. Date of contract: FORMCHECKBOX  Inheritance. Date of death: FORMCHECKBOX  Sale/leaseback  FORMCHECKBOX  Creation of a lease  FORMCHECKBOX  Assignment of a lease  FORMCHECKBOX  Termination of a lease. Date lease began:Original term in years (including written options): Remaining term in years (including written options): FORMCHECKBOX  Other. Please explain: C.Only a partial interest in the property was transferred.  FORMCHECKBOX  YES  FORMCHECKBOX  NO If YES, indicate the percentage transferred: %PART 3. PURCHASE PRICE AND TERMS OF SALECheck and complete as applicable. A.Total purchase price. $B.Cash down payment or value of trade or exchange excluding closing costsAmount $C. First deed of trust @% interest foryears. Monthly payment $Amount $ FORMCHECKBOX  FHA (___Discount Points) FORMCHECKBOX  Cal-Vet FORMCHECKBOX  VA(___Discount Points)  FORMCHECKBOX  Fixed rate FORMCHECKBOX  Variable rate FORMCHECKBOX  Bank/Savings & Loan/Credit Union FORMCHECKBOX  Loan carried by seller FORMCHECKBOX  Balloon payment $Due date:D.Second deed of trust @% interest foryears. Monthly payment $Amount $ FORMCHECKBOX  Fixed rate FORMCHECKBOX  Variable rate FORMCHECKBOX  Bank/Saving & Loan/Credit Union  FORMCHECKBOX  Loan carried by seller FORMCHECKBOX  Balloon payment $Due date:E. FORMCHECKBOX  Was an improvement Bond or other public financing assumed by the buyer? FORMCHECKBOX  YES FORMCHECKBOX  NOOutstanding balance $F.Amount, if any, of real estate commission fees paid by the buyer which are not included in the purchase price$G.The property was purchased:  FORMCHECKBOX  Through real estate broker. Broker name:Phone Number:( ) FORMCHECKBOX  Direct from seller  FORMCHECKBOX  From a family member-Relationship FORMCHECKBOX  Other. Please explain: H.Please explain any special terms, seller concessions, broker/agent fees waived, financing, and any other information (e.g., buyer assumed the existing loan balance) that would assist the Assessor in the valuation of your property. PART 4. PROPERTY INFORMATIONCheck and complete as applicable.A.Type of property transferred FORMCHECKBOX  Single-family residence FORMCHECKBOX  Co-op/Own-your-own  FORMCHECKBOX  Manufactured home  FORMCHECKBOX  Multiple-family residence. Number of units: FORMCHECKBOX  Condominium  FORMCHECKBOX  Unimproved lot  FORMCHECKBOX  Other. Description: (i.e., timber, mineral, water rights, etc.) FORMCHECKBOX  Timeshare FORMCHECKBOX  Commercial/Industrial B. FORMCHECKBOX  YES  FORMCHECKBOX  NO Personal/business property, or incentives, provided by seller to buyer are included in the purchase price. Examples of personal property are furniture, farm equipment, machinery, etc. Examples of incentives are club memberships, etc. Attach list if available.If YES, enter the value of the personal/business property:$Incentives $C. FORMCHECKBOX  YES  FORMCHECKBOX  NOA manufactured home is included in the purchase price.If YES, enter the value attributed to the manufactured home:$ FORMCHECKBOX  YES  FORMCHECKBOX  NO The manufactured home is subject to local property tax. If NO, enter the decal number:  D. FORMCHECKBOX  YES  FORMCHECKBOX  NOThe property produces rental or other income.If YES, the income is from:  FORMCHECKBOX  Lease/rent  FORMCHECKBOX  Contract  FORMCHECKBOX  Mineral rights  FORMCHECKBOX  Other:E.The condition of the property at the time of sale was:  FORMCHECKBOX  Good  FORMCHECKBOX  Average  FORMCHECKBOX  Fair  FORMCHECKBOX  PoorPlease describe:CERTIFICATIONI certify (or declare) 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. SIGNATURE OF BUYER/TRANSFEREE OR CORPORATE OFFICERDATETELEPHONE%( )NAME OF BUYER/TRANSFEREE/LEGAL REPRESENTATIVE/CORPORATE OFFICER (PLEASE PRINT)TITLEEMAIL ADDRESSThe Assessor s office may contact you for additional information regarding this transaction. ADDITIONAL INFORMATION Please answer all questions in each section, and sign and complete the certification before filing. 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 filing 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. NAME AND MAILING ADDRESS OF BUYER: Please make necessary corrections to the printed name and mailing address. Enter Assessors Parcel Number, name of seller, buyers daytime telephone number, buyers email address, and street address or physical location of the real property. NOTE: Your telephone number and/or email address is very important. If there is a question or a problem, the Assessor needs to be able to contact you. MAIL PROPERTY TAX INFORMATION TO: Enter the name, address, city, state, and zip code where property tax information should be mailed. This must be a valid mailing address. PRINCIPAL RESIDENCE: To help you determine your principal residence, consider (1) where you are registered to vote, (2) the home address on your automobile registration, and (3) where you normally return after work. If after considering these criteria you are still uncertain, choose the place at which you have spent the major portion of your time this year. Check YES if the property is intended as your principal residence, and indicate the date of occupancy or intended occupancy. DISABLED VETERAN: If you checked YES, you may qualify for a property tax exemption. A claim form must be filed and all requirements met in order to obtain the exemption. Please contact the Assessor for a claim form. PART 1: TRANSFER INFORMATION If you check YES to any of these statements, the Assessor may ask for supporting documentation. C,D,E, F: If you checked YES to any of these statements, you may qualify for a property tax reassessment exclusion, which may allow you to maintain your propertys previous tax base. A claim form must be filed and all requirements met in order to obtain any of these exclusions. Contact the Assessor for claim forms. NOTE: If you give someone money or property during your life, you may be subject to federal gift tax. You make a gift if you give property (including money), the use of property, or the right to receive income from property without expecting to receive something of at least equal value in return. The transferor (donor) may be required to file Form 709, Federal Gift Tax Return, with the Internal Revenue Service if they make gifts in excess of the annual exclusion amount. G: Check YES if the reason for recording is to correct a name already on title [e.g., Mary Jones, who acquired title as Mary J. Smith, is granting to Mary Jones]. This is not for use when a name is being removed from title. H: Check YES if the change involves a lender, who holds title for security purposes on a loan, and who has no other beneficial interest in the property. "Beneficial interest" is the right to enjoy all the benefits of property ownership. Those benefits include the right to use, sell, mortgage, or lease the property to another. A beneficial interest can be held by the beneficiary of a trust, while legal control of the trust is held by the trustee. I: A "cosigner" is a third party to a mortgage/loan who provides a guarantee that a loan will be repaid. The cosigner signs an agreement with the lender stating that if the borrower fails to repay the loan, the cosigner will assume legal liability for it. M: This is primarily for use when the transfer is into, out of, or between legal entities such as partnerships, corporations, or limited liability companies. Check YES only if the interest held in each and every parcel being transferred remains exactly the same. N: Check YES only if property is subject to a government or nonprofit affordable housing program that imposes restrictions. Property may qualify for a restricted valuation method (i.e., may result in lower taxes). O: If you checked YES, you may qualify for a new construction property tax exclusion. A claim form must be filed and all requirements met in order to obtain the exclusion. Contact the Assessor for a claim form. PART 2: OTHER TRANSFER INFORMATION A: The date of recording is rebuttably presumed to be the date of transfer. If you believe the date of transfer was a different date (e.g., the transfer was by an unrecorded contract, or a lease identifies a specific start date), put the date you believe is the correct transfer date. If it is not the date of recording, the Assessor may ask you for supporting documentation. B: Check the box that corresponds to the type of transfer. If OTHER is checked, please provide a detailed description. Attach a separate sheet if necessary. C. If this transfer was the result of an inheritance following the death of the property owner, please complete a Change in Ownership Statement, Death of Real Property Owner, form BOE-502-D, if not already filed with the Assessors office. PART 3: PURCHASE PRICE AND TERMS OF SALE It is important to complete this section completely and accurately. The reported purchase price and terms of sale are important factors in determining the assessed value of the property, which is used to calculate your property tax bill. Your failure to provide any required or requested information may result in an inaccurate assessment of the property and in an overpayment or underpayment of taxes. A. Enter the total purchase price, not including closing costs or mortgage insurance. Mortgage insurance is insurance protecting a lender against loss from a mortgagors default, issued by the FHA or a private mortgage insurer. B. Enter the amount of the down payment, whether paid in cash or by an exchange. If through an exchange, exclude the closing costs. Closing costs are fees and expenses, over and above the price of the property, incurred by the buyer and/or seller, which include title searches, lawyers fees, survey charges, and document recording fees. C. Enter the amount of the First Deed of Trust, if any. Check all the applicable boxes, and complete the information requested. A balloon payment is the final installment of a loan to be paid in an amount that is disproportionately larger than the regular installment. D. Enter the amount of the Second Deed of Trust, if any. Check all the applicable boxes, and complete the information requested. E. If there was an assumption of an improvement bond or other public financing with a remaining balance, enter the outstanding balance, and mark the applicable box. An improvement bond or other public financing is a lien against real property due to property-specific improvement financing, such as green or solar construction financing, assessment district bonds, Mello-Roos (a form of financing that can be used by cities, counties and special districts to finance major improvements and services within the particular district) or general improvement bonds, etc. Amounts for repayment of contractual assessments are included with the annual property tax bill. F. Enter the amount of any real estate commission fees paid by the buyer which are not included in the purchase price. G. If the property was purchased through a real estate broker, check that box and enter the brokers name and phone number. If the property was purchased directly from the seller (who is not a family member of one of the parties purchasing the property), check the Direct from seller box. If the property was purchased directly from a member of your family, or a family member of one of the parties who is purchasing the property, check the From a family member box and indicate the relationship of the family member (e.g., father, aunt, cousin, etc.). If the property was purchased by some other means (e.g., over the Internet, at auction, etc.), check the OTHER box and provide a detailed description (attach a separate sheet if necessary). H. Describe any special terms (e.g., seller retains an unrecorded life estate in a portion of the property, etc.), seller concessions (e.g., seller agrees to replace roof, seller agrees to certain interior finish work, etc.), broker/agent fees waived (e.g., fees waived by the broker/agent for either the buyer or seller), financing, buyer paid commissions, and any other information that will assist the Assessor in determining the value of the property. PART 4: PROPERTY INFORMATION A. Indicate the property type or property right transferred. Property rights may include water, timber, mineral rights, etc. B. Check YES if personal, business property or incentives are included in the purchase price in Part 3. Examples of personal or business property are furniture, farm equipment, machinery, etc. Examples of incentives are club memberships (golf, health, etc.), ski lift tickets, homeowners dues, etc. Attach a list of items and their purchase price allocation. 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