Declaration Of Documentary Transfer Tax (Page 2 of 2) in pdf

DECLARATION OF DOCUMENTARY TRANSFER TAX

The undersigned having knowledge of the transaction, does hereby disclose the following information to the Recorder of Los Angeles County for the

purpose of determining transfer tax on a conveyance of real property in which the controlling interest of a legal entity has transferred. You are required to

read the enclosed instruction sheet prior to completing this form. You may wish to consult your legal advisor.

NAME OF THE ACQUIRED LEGAL ENTITY

CONTACT PERSON TELEPHONE NUMBER

NAME OF THE ACQUIRING PERSON OR LEGAL ENTITY

EMAIL ADDRESS

CONTACT MAILING ADDRESS

CITY

STATE

ZIP CODE

Date ownership control (i.e., transfer of more than 50 percent of the ownership interests) was obtained:

___________________________

APN: __________________________________

STREET ADDRESS, CITY, ZIP: _____________________________________________________________

APN: __________________________________

STREET ADDRESS, CITY, ZIP: _____________________________________________________________

APN: __________________________________

STREET ADDRESS, CITY, ZIP: _____________________________________________________________

Change in Legal Entity Controlling Interest

COMPUTATION INFORMATION (as of date of conveyance)

Total Consideration/Value of the interest or property

$__________________________ / Percentage transferred _________%

Value obtained by appraisal

Yes__________ No__________

LESS: Liens or encumbrances remaining at the

$__________________________

time of transfer (i.e., loans assumed)

Amount tax based on

$__________________________

Countywide Tax ($.55 per $500, or $1.10 per $1000)

$__________________________

City Tax (if applicable) – See Instructions and Tax Bulletin

$__________________________

REASON FOR NO TAX DUE: (If this transfer is exempt from the documentary transfer tax, please complete this section, indicate the reason and submit

supporting documentation. Failure to provide supporting documentation may result in denial of your request.)

_ Instrument given to secure a debt. (RTC § 11921, LA CC § 4.60.040)

____

_____ Instrument or writing to which the US or any state or political subdivision is a party. (RTC §11922, LA CC § 4.60.050)

_____ Instrument involving bankruptcy, reorganization, receivership or change of identity. (RTC §11923, LA CC § 4.60.060)

_____ Securities and Exchange Commission Order Conveyance. (RTC § 11924, LA CC § 4.60.070)

_____ Transfer of Realty held by a continuing partnership. (RTC § 11925, LA CC § 4.060.080)

_____ Instrument taken in lieu of foreclosure. (RTC § 11926)

_____ Instrument transferring marital property. (RTC § 11927)

_____Transfer involving an Inter vivos gift, or upon death (RTC § 11930)

CERTIFICATION

I certify ( or declare ) under penalty of perjury that the foregoing and all information hereon, including any accompanying statements or documents, is true

and correct to the best of my knowledge and belief

SIGNATURE:

DATE

TELEPHONE

(

)

PRINT/TYPE NAME OF PERSON MAKING AFFIDAVIT

TITLE

EMAIL ADDRESS

LAvote.net

LArecorder.net

P.O. Box 1130, Norwalk, California 90651- 1130