Form Boe-502-Ah - Change In Ownership Statement

BOE-502-AH (P1) REV. 15 (05-13) ASSR-73 (REV. 8-16)

CHANGE IN OWNERSHIP STATEMENT

This statement represents a written request from the Assessor.

Failure to file will result in the assessment of a penalty.

FILE THIS STATEMENT BY:

NAME AND MAILING ADDRESS OF BUYER/TRANSFEREE

(Make necessary corrections to the printed name and mailing address)

ASSESSOR'S PARCEL NUMBER

8765-040-032

SELLER/TRANSFEROR

Richard T. Johnson

BUYER’S DAYTIME TELEPHONE NUMBER

(

)

592

123-4567

BUYER’S EMAIL ADDRESS

jmsmith@cox.net

STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY

33445 W. Maple Drive

MAIL PROPERTY TAX INFORMATION TO (NAME)

John M. and Marsha Smith

CITY

ZIP CODE

ADDRESS

STATE

33445 W. Maple Drive

So. Pasadena

CA 98765

This property is intended as my principal residence. If YES, please indicate the date of occupancy

DAY

YEAR

YES

23 2016

or intended occupancy.

PART 1. TRANSFER INFORMATION

Please complete all statements.

This section contains possible exclusions from reassessment for certain types of transfers.

YES

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.).

C. This is a transfer:

from grandparent(s) to grandchild(ren).

between parent(s) and child(ren)

D. This transfer is the result of a cotenant’s death. Date of death ____________________________

E. This transaction is to replace a principal residence by a person 55 years of age or older.

Within the same county?

YES

* 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?

YES

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:

H. The recorded document creates, terminates, or reconveys a lender's interest in the property.

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:

J. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.

K. This is a transfer of property:

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.

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.

3. to/from an irrevocable trust for the benefit of the

creator/grantor/trustor and/or

grantor's/trustor’s spouse

grantor’s/trustor’s registered domestic partner.

L. This property is subject to a lease with a remaining lease term of 35 years or more including written options.

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.

N. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.

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.

Please provide any other information that will help the Assessor understand the nature of the transfer.

THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION

Form Boe-502-Ah - Change In Ownership Statement - 2016

Related Articles

Related forms

Related Categories