Recording requested by (name):
When recorded mail to
and mail tax statements to:
Recorder’s Use Only
Declaration of Exemption From Gov’t Code § 27388.1 Fee
OR DOMESTIC PARTNER
Transfer is exempt from fee per GC § 27388.1(a)(2):
recorded concurrently “in connection with” transfer subject to DTT
SUCCEEDING TO TITLE
recorded concurrently “in connection with” a transfer of
(Cal. Prob. § 13540)
residential dwelling to an owner-occupier
Transfer is exempt from fee per GC 27388.1(a)(1):
Assessor’s Parcel No. (APN):
Fee cap of $225.00 reached
Not related to real property
____________________________________________, of legal age, being first duly sworn, deposes and says:
1. That ______________________________________, the decedent mentioned in the attached certified copy of
Certificate of Death, is the same person as _______________________________________, named as one of the parties
in that certain deed, dated ________________, executed by ______________________________________ to
community property with right of survivorship, recorded as Instrument No. _______________________ in Book/Reel
___________, Page/Image ____________, of Official Records of _________________________________ County,
California, covering the following described property situated in the City of __________________________, County of
___________________________, California (insert legal description):
2. That he/she was married to, or the registered domestic partner of the decedent at the time of his/her death.
3. That the above-described property has been at all times since acquisition considered the community property of
him/her and decedent.
4. More than forty (40) days have passed since the death of the above-named decedent, and no notice has been
recorded pursuant to section 13541 of the Probate Code.
5. That, with respect to the above-described property, there has not been nor will there be an election filed pursuant to
Probate Code Sections 13502 or 13503 in any probate proceedings in any court of competent jurisdiction.
6. That the above-described property has not passed to someone other than the affiant under the decedent’s will or by
7. That the property has not been disposed of in trust under the decedent’s will.
8. That the decedent’s will does not limit the affiant to a qualified ownership.
9. That this Affidavit is made for the protection and benefit of the surviving spouse, his/her successors, assigns and
personal representatives and all other parties hereafter dealing with or who may acquire an interest in the above-