PM 2019-0007ta (2�W
GEM ofthe DESERT —
MEMORANDUM
TO: Monika Radeva, City Clerk
FROM: Amy Yu, Associate Engineer
DATE: February 19, 2020
RE: Parcel Merger 2019-0007
Attached, please find Certificate of Parcel Merger and supporting exhibits for
the abovementioned, for recordation.
Document-9429042-Page-1
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RECORDING REQUESTED BY
CITY OF LA QUINTA
When recorded, return to:
CITY OF LA QUINTA
CITY CLERK
78-495 CALLE TAMPICO
LA QUINTA, CA. 92253
THIS AREA FOR RECORDER'S USE ONLY
DOC # 2020-0076101
02/19/2020 05:00 PM Fees: $0.00
Page 1 of 4
Recorded in Official Records
County of Riverside
Peter Aldana
Assessor -County Clerk -Recorder
"This document was electronically submitted
to the County of Riverside for recording"
Receipted by: ALYCIA #778
CERTIFICATE OF PARCEL MERGER NO. 2019-0007
RECORD OWNERS
EXISTING PARCELS (Assessor Parcel Numbers)
Jesse Allan Van Der Werf
767-700-015
& Danielle Nicole Van Der Wert
Jesse Allan Van Der Werf
767-700-016
& Danielle Nicole Van Der Werf
LEGAL DESCRIPTION OF MERGED PARCELS
See attached - Exhibit "A".aqd Exhibit "B"
SIGNATURE(5) OF RECORDED O N (S)4Must be Notarized
Prinr Name/rftle: Jesse Allan Van Der Werf
S7onature: L
Pn'nt Neme?rre: Danielle Nicole Van De_r Werf
' nature.
Print Na�ae:
FWN Na 2w Tnhw
Vamtwa:
This,,Qqrt1f1cate of Parcel Merger reflects Parcel Merger No. 2019-0007 as approved by the City of La Quinta.
_ Date:Z-/`j ZJZd
Bryarr2cKinney, P.E., City Engineer, R.C.E. No. 49418
NOTARY ACKNOWLEDGEMENT
A notary public or other officer completing this certificate verifies only the identity of the
Individual who signed the document, to which this certificate is attached, and not the
truthfulness, accuracy, or validit of that document
STATE OF CALIFORNIA j
COUNTY OF Riverside )
On February 14, 2020 before me, Amanda Tessandore, Notary Public
(Date) (Name and Me of otter)
personally appeared Jesse Allan Van Der Werf and Danielle Nicole Van Der Werf
(Nome(a) ofatrjner(s))
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capecity(ies),
and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s),
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the Sate of California that the foregoing paragraph is true and
correct.
MNINDATESSANDORE
HESS m hand a ial Se I , NowyPubUs-Cal'dtxnla
Y� (Cv' �J . ' Riv1won County
,fn1Fti, ` Commis�on # 2224752
My Comm. Egimt Dac26,2021
NOWY Public
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Document-9429042-Page-2
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DOC #2020-0076101 Page 2 of 4
A notary public or other officer completing this certificate verifies only the
identity of the individual who signed the document, to which this certificate
is attached, and not the truthfulness, accuracy, or validity of that document
State of California
County of Riverside
On FEBRUARY 19, 2020 before me, TANIA FLORES , Notary Public,
personally appeared BRYAN MCKINNEY who proved to me on the basis of
satisfactory evidence to be the person whose name is subscribed to the within
instrument, and acknowledged to me that he executed the same in his
authorized capacity, and that by his signature on the instrument the person, or
the entity upon behalf of which the person acted, executed the instrument.
I certify under PENALTY. OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
WITNESS my hand a d official seal.
Signature
(seal)
TANIA M. FLORES
Notary Public - California
Riverside County
Commission / 2301294
My Comm. Expires rug 18, 2023
DOCUMENT:
CERTIFICATE OF PARCEL MERGER NO. 2019-0007 re: APN 767-700-015
and 767-700-016 — owner(s): JESSE ALLAN VAN DER WERF and DANIELLE
NICOLE VAN DER WERF
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Document-9429042-Page-3
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EXHIBIT "A"
LEGAL DESCRIPTION
PARCEL MERGER 2019-0007
PARCEL "A"
DOC #2020-0076101 Page 3 of 4
That certain parcel of land located In the City of La Quinta, County of Rlverside, State of California, being
all of Lot 63 and all of Lot 64 of Tract No. 33076-2, as shown by a map on file in Book 393 of Maps, pages
61 through 80 inclusive, Records of said County.
CONTAINING: 1.54 Acres, (67,062 Square Feet), more or less.
SUBJECT TO all Covenants, Rights, Rights -of -Way and Easements of record.
Graphically depicted on 'EXHIBIT "B"', attached hereto and by this reference made a part hereof.
This Certificate of Parcel Merger reflects Parcel Merger No. 2019-0007, as approved by the City of La
Quinta.
This legal description was prepared
by me or under my direction.
-�
Benjarfrin Daniel Egan, PLS 8756
Prepared: January 14, 2020
Page 1 of 1
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I ADJUSTMENT PLAT - CITY OF LA QUINTA I
PREPARED BY:
BENJAMIN DANIEL EGAN, PLS 8756
JANUARY 14, 2020
DATE
LAND
NO. 8756�
OF CA
Document-9429042-Page-1
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130E-502-A (P1) REV.13 (08-17)
PRELIMINARY CHANGE OF OWNERSHIP REPORT
To be completed by the transferee (buyer) prior to a transfer of subject
property, in accordance with section 4$0.3 of the Revenue and Taxation
Code. A Preliminary Change of Ownership Report must be filed with
each conveyance In the County Recorder's office for the county
where.lhe property is located.
FOR ASSESSOR'S USE ONLY
r
L
PETER ALDANA, COUNTY OF RIVERSIDE
ASSESSOR -COUNTY CLERK -RECORDER
PO BOX 751, RIVERSIDE, CA 92502-0751
(951) 955-0400 www.dversideacr.com
PARCEL NUMBER
-76"7-
RlrRNV9FER
J BUYER'S EMAILAO DRESS
COT tS'f y JQAOL f+�, L¢ PG1fGrua
❑ YES [WNO This property is intended as my principal residence. If YES, please Indicate the dale of occupancy MO pnv YEAR
or Intended occupancy
[]YES R NO Are you a disabled veteran or a unmarried surviving spouse of a disabled veteran who was
ccmpensaled at 100% by the Department of Veterans Affelrs?
FAIL PROPERTYTAX INFORMATION TO(NAME]
MAIL PROPERTYTAX INFORMATION TO (ADDRESS) cfrf
s1-?YC 80A,&- )ZQ', .231 y6c"IF&I" P%olp rya 1 7'
PART 1. TRANSFER INFORMATION Please complefe allstate171en1s. C~110,
YES NO /� '4/�4�
This section contains possible exclusions from reassessment for certain types of transfer�� LIf ex r y
� /f� (�
❑ N1 A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
❑ 4 B. This transfer Is solely between domestic partners currently registered with the California Secretary of State (addi"lion or removal of
a partner, death of a partner, termination settlement, eta).
❑ C. This is a transfer: ❑ between parent(s) and children) ❑ from grandparent(s) to grendchild(ren).
❑ N * D. This transfer is the result of a cotenant's death. Date of death
❑ * E. This transaction Is to replace a principal residence owned by a person 55 years of age or older.
Within the same county? []YES ❑ NO
❑ Q* F. This transaction is to replace a principal residence a per3an who Is severely disabled as defined by Revenue and Taxation Code
section 69.5. Wlthln the same county? ❑ YES �❑ NO
❑ Q G. This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage).
If YES, please explain:
❑ H. The recorded document creates, terminates, or reconveys a lenders Interest in the property.
❑ I. This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security. interest
(e.g., cosigner). If YES, please explain:
❑ ® J. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
K This Is a transfer of property:
❑ ra 1. tolfrom a revocable trust that may be revoked by the transferor and Is for the benefit of
❑ the transferor, andlar ❑ the transferors spouse ❑ registered domestic partner.
❑ ® 2. tolfrom an Irrevocable trust for the benefit of the
❑ creator/grantoritrustor and/or ❑ grantors/trustor's spouse ❑ grantor'shrustor's registered domestic partner.
❑ ® L. This property is subject to a lease with a remaining lease term of 35 years or more including written options.
❑ M. This is a transfer between parties in which proportional interests of1he transferor(s) and transferees) in each and every parcel
being transferred remain exactly the same after the transfer. fi410Ctz /"Lr@J;:W_ 4.,
❑ N. This is a transfer subject to substdixed low-income housing requirements with governmentally imposed restrictions, or restrictions
imposed by specified nonpmfil corporations.
❑ ®� O. This transfer is to the first purchaser of a new building containing an active solar energy system.
❑ P. Other. This transfer is to
' Please refer to the instructions for Part 1.
Please provide any other Information that will help the Assessor understand the nature of the transfer.
THIS DOCUMENT IS.NOT.SUBJECT TO.PUBLIC INSPECTION
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BOE-502•A (P2) REV. 13 (06-17)
PART 2.OTHER TRANSFER INFORMATION Check and complete as applicable.
A. Date of transfer, if other than recording date:
B. Type of transfer.
❑ Purchase ❑ Foreclosure ❑ Gift ❑ Trade cr exchange ❑ Merger, stock, or partnership acquisition (Form BOE-100,B)
❑ Contract of sale. Date of contract: ❑ Inheritance. Date of death:
❑ Sale/leaseback ❑ Creation of a lease ❑ Assignment of a lease ❑ Termination of a lease. Date lease began:
Origi 1 term Ingars (including written o lions): _ Remaining term in years (including written options):
Other. Please explain:
C. Only a partial interest in the property was transferred, YES []NO If YES, Indicate the percentage transferred: %
PART 3. PURCHASE PRICE AND TERMS OF SALE Check and complete as applicable.
A. Total purchase price Is
B. Cash down payment orvalue of trade or exchange excluding closing costs Amount $
C. First deed of trust @ % interest for years. Monthly payment S Amount 5
❑ FHA Discount Points) ❑ Cal -Vet ❑ VA (_Discount Points) ❑ Fixed rate ❑ Variable rate
❑ Bank/savings & Loan/Credit Union ❑ Loan carried by seller
Balloon payment $ Due date:
D. Second deed of trust @ % interest for years. Monthly payment $ Amount $
❑ Fixed rate ❑ Variable rate ❑ Bank/Savings & Loan/Credit Union ❑ Loan carried by seller
❑ Balloon payments Due date:
E. Was.an Improvement Bond or other public financing assumed by the buyer? YES ❑ NO Outstanding balance $
F. Amount, if any, of real estate commission fees paid by the buyer which are not Included In the purchase price S
G. The property was purchased: ❑Through real estate broker. Broker name: Phone number. 7
❑ Direct from seller ❑ From a family member-Relationshlp
❑ Other. Please explain:
H. Please explain any special terms, seller concessions, broker/agent fees waived, financing, and any other information (e.g., buyer assumed the
existing loan balance) that would assist the Assessor in the valuation of your property.
PART 4. PROPERTY INFORMATION Check and complete as applicable.
A. Type of property transferred
❑ Single-family residence Co-optown-your-own Manufactured home
❑ Mufiiple-family residence. Number of units:_ ❑ Condominium Unimproved lot
❑ Other. Description: (i.e., timber, mineral, water rights, etc.) ❑ Timeshare Commercial/Industrial
B. ❑YES N NO Persenallbusiness property, or incentives, provided by seller to buyer are Included in the purchase price. Examples of personal
property are furniture, farm equipment, machinery, etc. Examples dfincentives are ctub memberships, etc.Attach list if available.
If YES, enter the value of the personallbusiness property: $ Incentives $
C.❑YES [NNO A manufactured home is included In the purchase price.
If YES, enter the value attributed. to the manufactured home: $
❑YES ®NO The manufactured home Is sugject to local property tax. If NO, enter decal number.
D. ❑YES N,,!NO The property produces rental or other income.
If YES, the income is from: ❑ Laase/rent ❑ Contract ❑ Mineral rights ❑ Other.
E. The condition of the property at the time of sale was: Good ElAverage E]Falr ❑ Poor
Please descdbe:L►
CERTIFICATION
I certify for declare) that the foregoing and all information hereon, including any accompanying statements or documents, is Prue and correct to
the b my knowledge and belief.
5I ATl11tE 6 I1YEWr, SFEAE COf2PORATE OFF CER DATE TELEPHONE
ha
NA E RANSFEREEIPERSONALRE NTAT C O 7E OFFICER IPLEASE PRINT) TITLE EIAAII- DORESS Teo
JIF5r 115W bt:� oH940 1"74r' 00.11,
The Assessor's office may contact you for additional Information regarding this transaction.=JC�• G!3"
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Document-9429042-Page-3
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PETER ALIDANA Box
P.O.P..O. ox751
COUNTY OF RIVERSIDE Riverside. CA 92502-0751
ASSESSOR -COUNTY CLERK -RECORDER (951)48G 7.00D
#.. " Website: w vw-rives
DOCUMENTARY TPANSF ER TAX AFFIDAVIT I
W an>x1vIN!G
ANY PERSON WOO MAKES ANY MATERIAL MISREPRESENTATiON OF FACT FOR THE PURPOSE OF AVOIDING ALL OR ANY PART
OF THE DOCUMENTARY TRANSFER TAX IS GUILTY OF A MISDEMEANOR UNDER SECTION 5 OF ORDINANCE 516 OF THE COUNTY
OF RIYERSIUE. AND issL1amcrT0 PROSECIITION FOR SUCH OFFENSE.
ASSESSOR'S PARCEL NO. 7 —_ p( 1 declare that the documen ansfer tax for this
Property Address: ui9 04,*L transact ion is: $
If this transaction is exempt from Documentary Transfer Tax, the reason must be identified below.
I CLAIM THAT THIS TRANSACTIONIS EXaM7PT FROA9 DOCUMENTARY TRANSFER TAXBECAUSE: (The
Seclions iisled belatp are taken from the Revenue and Taxation Code with The exceplfon of items 9 and Ili w ich are taken
front Riverside Courtly Ordinance 5I6). Please chick one or explain in "Other".
I . Section 11911. The consideration or value of the property, exclusive of any liens and enctungrances is
$100:00 or less and there is no additional consideration received by the grantor.
2. _Section 11911. The conveyance transfers to a revocable living trust by the grantor or from a [;evocable living
trust to a beneficiary..
3. _Section 11921. The conveyance was given to secure a debt.
4. Section 11922. The conveyance is to a governmental entity or political subdivision.
5. Section 11925. The transfer is between individuals and a legal entity or pa1'Inership, or between
legal entities and does not change the proportional interests held.
6. _Section 11926. The conveyance is to a grantee who is the foreclosing beneficiary and the consideration paid by
the foreclosing beneficiary does not exceed the unpaid debt. i
7. _Section 11927. The conveyance relates to a dissolution of marriage or legal separation.
(A spouse must sign o written recital in order to claim this exemption. This form may be used fo+ that purpose.)
8. _Section 11930. The conveyance is an inter vivn,s gift' or a transfer by death.
•Please be aware that information sla te d on tbis document may be given to and used by governmental
agencies, including tha [eternal Revenue Service. Also, certain gifts in excess of the annual Federal gift tax
exemption may trigger a Federal Gift Tax. In such cases, the Transferor (donor/grantor) may be required to
file Form 709 (Federal GiftTax Return) with the Internal Revenue Service.
9. _Section 8. The easement is &[.perpetual, permanent, or for life.
10. _Section 9. The document is a lease for a term of LgaLthan (35) years (including written options.)
11. __Other {Include explanation and legal authority)
!DECLARE UNDER PENALTY OFPERJUR Y THA T THE f•OREIGOING IS TCRUEAND CORRECT.
ec t this yof G, 2U iri at` c� 2�' as city �� .�.-; state
Signat ol'Affiant Printed Nazse ofAlfrent U�
Name brf4m (if eppl[cabisj Address -of Af%x (ineludini; City. State, and Zip Code)
Telephone Number of Afftanl (includatg area code)
LLt,
^'i4lt:rr
Phis form is suh�eet to the Cal3fnrnia Public Records Act (Government Code 6250 et serf.)
For Recorder's Use:
ACR 521 (Rev. 11/2014)
Affix PCOR Label Here
Available in Alternate Formats
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