Prelimnary Change Of Ownership Report Form - San Bernardino, California

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PRELIMINARY CHANGE OF OWNERSHIP REPORT
For Recorders Use Only
(To be completed by transferee [buyer] prior to transfer of subject property
in accordance with Section 480.3 of the Revenue and Taxation Code.)
THIS REPORT IS NOT A PUBLIC DOCUMENT
Seller/Transferor:
For Assessor’s Use Only
Buyer/Transferee:
Assessor's Parcel Number(s):
Con ___________________
Property Address or Location:
Adj ___________________
Mail Tax Information To:
Name
Address
Phone Number (8 a.m.-5 p.m.):
A Preliminary Change in Ownership Report
must be filed with each conveyance in the
County Recorder's office for the county
NOTICE: A lien for property taxes applies to your property on January1 of each year for the taxes owing in the following fiscal year,
where the property is located; this particular
July 1 through June 30. One-half of these taxes is due November 1, and one-half is due February 1. The first installment becomes
form may be used in all 58 counties of
delinquent on December 10, and the second installment becomes delinquent on April 10. One tax bill is mailed before November 1 to
California.
the owner of record. IF THIS TRANSFER OCCURS AFTER JANUARY 1 AND ON OR BEFORE DECEMBER 31, YOU MAY BE
RESPONSIBLE FOR THE SECOND INSTALLMENT OF TAXES DUE FEBRUARY 1.
The property which you acquired may be subject to a supplemental assessment in an amount to be determined by the San Bernardino County
Assessor. For further Information on your supplemental roll obligation, please call the San Bernardino County Assessor at (909) 387-8307.
PART I: TRANSFER INFORMATION
Please answer all questions
YES NO
A.
Is this transfer solely between husband and wife? (Addition of a spouse, death of a spouse, divorce settlement, etc.)
B.
Is this transaction only a correction of the name(s) of the person(s) holding title to the property? (For example, a name change upon marriage)?
C.
Is this document recorded to create, terminate, or reconvey a lender's interest in the property?
D.
Is this transaction recorded only as a requirement for financing purposes or to create, terminate or reconvey a security interest (e.g., cosigner)?
E.
Is this document recorded to substitute a trustee under a deed of trust, mortgage, or other similar document?
F.
Did this transfer result in the creation of a joint tenancy in which the seller (transferor) remains as one of the joint tenants?
G.
Does this transfer return property to the person who created the joint tenancy (original transferor)?
H.
Is this transfer of property:
1. to a trust for the benefit of the
Grantor
Grantor’s spouse
a. I am/We are still eligible for the Homeowners Exemption and wish to keep this exemption.
Yes
No
2. to a trust revocable by the transfer?
3. to a trust from which the property reverts to the grantor within 12 years?
I.
If this property is subject to a lease, is the remaining lease term 35 years or more including written options?
*
J.
Is this a transfer between parent(s) and child(ren)?
or from grandparent(s) to grandchild(ren)?
*
K.
Is this transaction to replace a principal residence by a person 55 years of age or older? Within the same county?
Yes
No
*
L.
Is this transaction 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
No
*If you checked "Yes” to J, K or L, you may qualify for a property tax reassessment exclusion, which may result in lower taxes on your property. Failure to file a claim results in the
reassessment of the property.
Please provide any other information that would help the Assessor to understand the nature of the transfer.
IF YOU HAVE ANSWERED “YES” TO ANY OF THE ABOVE QUESTIONS EXCEPT J, K or L PLEASE SIGN AND DATE,
OTHERWISE COMPLETE BALANCE OF FORM.
PART II: OTHER TRANSFER INFORMATION
A.
Date of Transfer, if other than recording date ____________________________
B.
Type of transfer. Please check appropriate box.
Purchase
Foreclosure
Gift
Trade or Exchange
Merger, Stock or Partnership Acquisition
Contract of Sale – Date of Contract ___________________________
Inheritance – Date of Death ______________________________
Other (Please Explain) _______________________________________
Creation of Lease
Assignment of a Lease
Termination of a Lease
Sale/Leaseback
Date lease began ____________________________
Original term in years (including written options) ___________________________
Remaining term in years (including written options) ___________________________
C.
Was only a partial interest in the property transferred?
Yes
No
If “Yes”, indicate the percentage transferred _____________________________ %
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