Transfer Tax Affidavit

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C
C
S
F
ITY AND
OUNTY OF
AN
RANCISCO
O
A
-R
FFICE OF THE
SSESSOR
ECORDER
TRANSFER TAX AFFIDAVIT
FOR RECORDER’S USE ONLY
Document Series Number:
NOTICE: ANY MATERIAL MISREPRESENTATION OF FACT IN THIS AFFIDAVIT IS A MISDEMEANOR UNDER
REAL PROPERTY TRANSFER TAX ORDINANCE SECTION 1116. ANY PERSON WHO MAKES SUCH A
MISREPRESENTATION IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE.
1. LOCATION OF PROPERTY:
Block:
Lot:
Street Address:
Type of document to be recorded:
2. IS THIS A FORECLOSURE/DEED IN LIEU OF FORECLOSURE OR A TRUSTEE SALE?
Yes (Complete this section)
No (Proceed to #3)
a. Is the Transferee the foreclosing Beneficiary or Mortgagee?
Yes
No
b. Is the Transferee foreclosing a Senior Loan?
Yes
No (Enter amount(s) of Senior Loan(s) $
and proceed to #6
3. IS THIS A LEASE?
Yes (Complete this section)
No (Proceed to #4)
a. Is remaining term of lease including renewal options equal or greater than 35 years?
Yes (Complete i and ii)
No (No transfer tax is due)
i. If yes, submit copy of lease or summary of terms and
indicate consideration or Value of leasehold interest: $
ii. Enter amount on line 6a for tax calculation
4. IS THIS A GIFT IN WHOLE OR IN PART?
Yes (Complete this section and proceed to #7)
No (Proceed to #5)
Enter the fair market value: $
Name of Transferor/Donor:
Name of Transferee/Donee:
Please be aware that certain gifts in excess of $14,000 per calendar year may trigger a Federal Gift Tax.
In such cases, the Transferor/Donor may be required to file Form 709 (Federal Gift Tax Return) with the
Internal Revenue Service. Please also be aware that information stated on this document may be given
and used by governmental agencies, including the Internal Revenue Service.
I,
, as the Transferor/Donor, declare under penalty of perjury,
that I have read the aforementioned paragraph and acknowledge that a Federal Gift Tax may be
triggered.
(Transferor/Donor signature)
Page 1 of 2
1 Dr. Carlton B. Goodlett Place, Room 190
Tel: (415) 554-5596
Fax: (415) 554-7151
San Francisco, CA 94102-4698

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