If YES, please indicate the date of occupancy
or intended occupancy.
PART 1. TRANSFER INFORMATION
Please complete all statements.
This section contains possible exclusions from reassessment for certain types of transfers.
YesNo
A.
This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
YesNo
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.).
YesNo
*C.
This is a transfer:
between parent(s) and child(ren)
from grandparent(s) to grandchild(ren).
YesNo
*D.
This transfer is the result of a cotenant’s death. Date of death
YesNo
*E.
This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county?
YesNo
YesNo
*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?
YesNo
YesNo
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).
YesNo
H.
The recorded document creates, terminates, or reconveys a lender's interest in the property.
YesNo
I.
This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest
(e.g., cosigner).
YesNo
J.
The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
K. This is a transfer of property:
YesNo
1.
to/from a revocable trust that may be revoked by the transferor and is for the benefit of
the transferor, and/or
the transferor's spouse
registered domestic partner
YesNo
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 beneficiaries when the creator/grantor/trustor dies.
YesNo
3.
to/from an irrevocable trust for the benefit of the
This property is subject to a lease with a remaining lease term of 35 years or more including written options.
YesNo
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.
YesNo
N.
This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
YesNo
*O.
This transfer is to the first purchaser of a new building containing an active solar energy system.
* Please refer to the instructions for Part 1.
PART 2. OTHER TRANSFER INFORMATION
Check and complete as applicable.
A. Date of transfer, if other than recording date:
B. Type of transfer
PurchaseForeclosureTrade or exchange
Sale/leasebackCreation of a leaseAssignment of a lease
GiftMerger, stock, or partnership acquisition (Form BOE-100-B)
Contract of sale
Inheritance
Termination of a lease.
Other
C.
Only a partial interest in the property was transferred.
YesNo
PART 3. PURCHASE PRICE AND TERMS OF SALE
Check and complete as applicable.
A. Total purchase price
B. Cash down payment or value of trade or exchange excluding closing costs
C. First deed of trust at
% interest for
years. Monthly payment $
Bank/Savings & Loan/Credit Union
Loan carried by seller
Balloon payment
D. Second deed of trust at
% interest for
years. Monthly payment $
Fixed rate
Variable rate
Bank/Savings & Loan/Credit Union
Loan carried by seller
Balloon payment
E. Was an Improvement Bond or other public financing assumed by the buyer?
YesNo
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:
Through real estate broker
Direct from seller
From a family member
Other
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 INFORMATION
Check and complete as applicable.
A. Type of property transferred
Single-family residence
Co-op/Own-your-own
Manufactured home
Condominium
Unimproved lot
Timeshare
Commercial/Industrial
Multiple-family residence
Other. Description
B.
YesNo
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
C.
YesNo
A manufactured home is included in the purchase price.
If YES, enter the value attributed to the manufactured home
YesNo
The manufactured home is subject to local property tax
D.
YesNo
The property produces rental or other income.
If YES, the income is from:
Lease/rent
Contract
Mineral rights
Other
E. The condition of the property at the time of sale was
Good
Average
Fair
Poor
CERTIFICATION
I 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.