Form Boe-100-B (S1) - Statement Of Change In Control And Ownership Of Legal Entities Page 7
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10Schedule A continued
BOE-100-B (S2B) REV. 21 (1-12)
4. Transfer Information: Complete all statements as they pertain to ownership interest of a legal entity(ies); not transfers of real
property interests.
YES
NO
a. This transfer was solely between spouses or registered domestic partners. If transfer was due to death, provide
date of death:
b. This transfer of ownership interest was between parties (for example, a transfer into or out of a legal entity or a
transfer between legal entities) in which the proportional ownership interests of the transferor(s) and
transferee(s) remain exactly the same before and after the transfer.
c. This transfer of ownership interest was a nontaxable reorganization between corporations which are members of
an affiliated group before and after the transfer.
If you answered "yes" to item b or c listed above, you must attach additional documentation. (See Instructions for documentation
required).
5. Real Property Schedule:
Please list all interests in real property in California held by the acquired legal entity (or any legal entity(ies) under its ownership
control), as of the date that ownership control was obtained (the acquisition date). See instructions for definition of "interests in
real property." Also attach a list identifying the name and identification number of each entity under the acquired entity's
control.
a. Property
Owned
by Acquired Legal Entity and Entities Under its Control
TYPE OF PROPERTY
(CHECK ALL THAT APPLY)
LOCATION
ASSESSOR'S
NAME OF OWNER
CO.
(STREET ADDRESS/CITY)
PARCEL NO.
IMPROVEMENTS
NO.
FIXTURES
LAND
(BLDG./STRUCTURE)
b. Please list property
Leased
by Acquired Legal Entity and Entities Under its Control
TYPE OF LEASE
(CHECK ALL THAT APPLY)
LOCATION
ASSESSOR'S
CO.
NAME OF LESSEE
PUBLIC ENTITY
LEASED 35+ YEARS
(STREET ADDRESS/CITY)
PARCEL NO.
NO.
(POSSESSORY
(REMAINING TERM
INTEREST)
INCLUDING OPTIONS)
COUNTY IDENTIFICATION NUMBERS
01 Alameda
13 Imperial
25 Modoc
37 San Diego
49 Sonoma
02 Alpine
14 Inyo
38 San Francisco
50 Stanislaus
26 Mono
03 Amador
15 Kern
39 San Joaquin
51 Sutter
27 Monterey
04 Butte
16 Kings
40 San Luis Obispo
52 Tehama
28 Napa
05 Calaveras
17 Lake
41 San Mateo
53 Trinity
29 Nevada
06 Colusa
18 Lassen
42 Santa Barbara
54 Tulare
30 Orange
07 Contra Costa
19 Los Angeles
43 Santa Clara
55 Tuolumne
31 Placer
08 Del Norte
20 Madera
44 Santa Cruz
56 Ventura
32 Plumas
09 El Dorado
21 Marin
45 Shasta
57 Yolo
33 Riverside
10 Fresno
22 Mariposa
34 Sacramento
46 Sierra
58 Yuba
11 Glenn
23 Mendocino
47 Siskiyou
35 San Benito
12 Humboldt
24 Merced
48 Solano
36 San Bernardino
STATE USE ONLY
RESULT/REASON CODE
ENTITY NAME
ENTITY ID NUMBER
CIC DATE
DATE ENTERED
No CIC of FLE-
Reporting a CIC (33)
Change in Control (77):
Exclusion Applies (88):
No Change in Control (99):
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