Prelimnary Change Of Ownership Report Form - San Bernardino, California Page 2
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2PRELIMINARY CHANGE OF OWNERSHIP REPORT
Please answer, to the best of your knowledge, all applicable questions, sign and date. If a question does not apply, indicate with “N/A”.
PART III: PURCHASE PRICE AND TERMS OF SALE
A. CASH DOWN PAYMENT OR Value of Trade or Exchange (excluding closing costs)
Amount $ ____________________
B. FIRST DEED OF TRUST @ ______ % interest for ______ years. Payments per Month= $ _____________ (Principal & Interest only)
Amount $ ____________________
FHA (_____ Discount Points)
Fixed Rate
New Loan
Conventional
Variable Rate
Assumed Existing Loan Balance
VA (_____ Discount Points)
All Inclusive D.T. ($____________ Wrapped)
Bank or Savings & Loan
Cal-Vet
Loan Carried by Seller
Finance Company
Balloon Payment
Yes
No
Due Date _______________________
Amount $ ____________________
C. SECOND DEED OF TRUST @ ______ % interest for ______ years. Payments per Month= $ _____________ (Principal & Interest only)
Amount $ ____________________
Bank or Savings and Loan
Fixed Rate
New Loan
Loan Carried by Seller
Variable Rate
Assumed Existing Loan Balance
Balloon Payment
Yes
No
Due Date _______________________
Amount $ ____________________
D.
OTHER FINANCING: Is other financing involved not covered in (b) or (c) above?
Yes
No
Type _____________________ @ ______ % interest for ______ years. Payments per Month= $ _____________ (Principal & Interest only) Amount $ ____________________
Bank or Savings and Loan
Fixed Rate
New Loan
Loan Carried by Seller
Variable Rate
Assumed Existing Loan Balance
Balloon Payment
Yes
No
Due Date _______________________
Amount $ ____________________
E. WAS AN IMPROVEMENT BOND ASSUMED BY THE BUYER?
Yes
No
Outstanding Balance:
Amount $ ____________________
F. TOTAL PURCHASE PRICE (or acquisition price, if traded or exchanged, include real estate commission if paid.)
$
0.00
Total Items A through E
G. PROPERTY PURCHASED
Through a broker
Direct from Seller
From a family member
Other (explain) _________________________________________
If purchased through a broker, provide broker’s name and phone number:
Please explain any special terms, seller concessions or financing and any other information that would help the Assessor understand the purchase price and terms of sale.
PART IV: PROPERTY INFORMATION
A. TYPE OF PROPERTY TRANSFERRED:
Single Family Residence
Agricultural
Timeshare
Multiple Family Residence (no. of units __________)
Co-op/Own-your-own
Manufactured Home
Commercial/Industrial
Condominium
Unimproved Lot
Other (Description: _____________________________________________________________________________ )
B. IS THIS PROPERTY INTENDED AS YOUR PRINCIPAL RESIDENCE?
Yes
No
If yes, enter date of occupancy _______________________________
or intended occupancy _____________________________________
Month
Day
Year
Month
Day
Year
C. IS THIS PERSONAL PROPERTY INCLUDED IN PURCHASE PRICE (i.e. furniture, farm equipment, machinery, etc.)
(other than a manufactured home subject to local property tax)?
Yes
No
If yes, enter the value of the personal property included in the purchase price $ ________________________ (Attach itemized list of personal property)
D. IS A MANUFACTURED HOME INCLUDED IN PURCHASE PRICE?
Yes
No
If yes, how much of the purchase price is allocated to the manufactured home? $___________________________
Is the manufactured home subject to local property tax?
Yes
No
What is the Decal Number? ______________________________
E. DOES THE PROPERTY PRODUCE INCOME?
Yes
No
If yes the income is from:
Lease/Rent
Contract
Mineral Rights
Other – Explain ______________________________________________________
F. WHAT WAS THE CONDITION OF PROPERTY AT THE TIME OF SALE?
Good
Average
Fair
Poor
Please explain the physical condition of the property and provide any other information (such as restrictions, etc.) that would assist the Assessor in
determining the value of the property.
I certify that the foregoing is true, correct and complete to the best of my knowledge and belief.
Signed _____________________________________________________________________________________________ Date ________________________
NEW OWNER / CORPORATE OFFICER
Please print Name of New Owner / Corporate Officer _____________________________________________________________________________________
Phone Number where you are available from 8:00 a.m. – 5:00 p.m. _________________________________
(NOTE: The Assessor may contact you for further information)
If a document evidencing a change of 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 ($20.00).
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