LLA 2016-0001 Parcel BRECORDING REQUESTED BY
David SIIvey and Krlata SIIvey
WHEN RECORDED MAIL TO
AND MAIL TAX STATEMENTS TO
David SIIvey and Krista Silvey
24397 S.W. Valley View Road
West Linn, OR 97068
AND FURNISH A COPY TO
City of La Qulnta
78495 Calle Tampico
La Quinta, CA 92253
QUITCLAIM DEED
LLA 2016-0001
TITLE ORDER NO. ESCROW NO.
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX Is $
0
2016-0310499
07/25/2016 10:39 AM
***Customer Copy Label***
The paper to which this label is affixed
has not been compared with the
filed/recorded document
Peter Aldana
County Of Riverside
Assessor -County Clerk -Recorder
APN NO. 777-170-013 & 777-170-014
CITY TAX
❑ computed on full value of property conveyed, or 0 computed on full value Tess value of liens or encumbrances remaining at
time of sale,
❑ Unincorporated area: 0 City of , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Peter S. Borden, and Jennifer S. Borden, Peter S. Borden and Jennifer S. Borden, Trustees of the
Borden Family Trust dated March 18, 2010
and
David Silvey and Krista Silvey, husband and wife as Joint tenants
hereby QUITCLAIMS(s) to
David Silvey and Krista Slivey, husband and wife as joint tenants
the following described real property in the City of La Quinta, County of Riverside, State of California:
Parcel "B" (Adjusted Lot 326) of Lot Line Adjustment 2016-0001 approved by the City of La Quanta,
as depicted on Exhibits "A" and "B", attached hereto and by this reference made a part hereof.
NOTE: This Grant Deed perfects the intent of Lot Line Adjustment 2016-0001 as approved by the
City of La Quanta.
Borden Fail us datt d arch 18 2010
‘////7/4'
Jam{
•
Peter S.gten, Trus ee Date
bra¢ t
Jennifer S. Borden,Dafe
David Silvev and Krista Silvev
ThiQQuitclaim Deed reflects Lot Line Adiustment
2016-0001 as Approved by the City of La Quinta.
7,4 f46
David Silvey
Krista ilvey
Date
Date
othy R. J in n, P.E., Date
Public Work D ctor/
City Engineer, RCE No. 45843
STATE OF CALIFORNIA ) S.S
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 I5 ATTACHED, AND NOT THE TRUTHFULNESS,
ACCURACY, OR VALIDITY OF THAT DOCUMENT.
COUNTY OF RIV )CLS. i6-9-e1es
ON 6 /1 zs , 2016 , BEFORE ME, A.' re u P -Q )Z S ,�t� A NOTARY PUBLIC,
PERSONALLY APPEARED N ,c' S, D' et'ota,r, , WHO PROVED TO ME ON THE BASIS
OF SATISFACTORY EVIDENCE TO BE THE PERSON(S) WHOSE NAME(S) SUBSCRIBED TO THE
WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT I / SHE /THEY EXECUTED THE SAME IN ei
-1444% -4-.1.1:04- AUTHORIZED CAPACITY(IES), AND THAT BY � SIGNATURE 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 STATE OF CALIFORNIA THAT THE
FOREGOING PARAGRAPH IS TRUE AND CORRECT.
0(.00,41-
WITNESS MY HAND AND SvvEAL:
SIGNATURE
NOTARY PUBLIC IN AND FOR SAID STATE
MY COMMISSION EXPIRES 3 /
MY COMMISSION NUMBER 2 09 qd 6'Z
MY PRINCIPAL PLACE OF BUSINESS I5 INc.6* C
ANDREW HOLZSAUR
NOTARY PUBUC • CALIFORNIA
COMMISSION # 2099082
LOS ANGELES COUNTY
MZ Comm. Exp. March S 2019
COUNTY.
STATE OF CALIFORNIA ) S.S
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 I5 ATTACHED, AND NOT THE TRUTHFULNESS,
ACCURACY, OR VALIDITY OF THAT DOCUMENT.
COUNTY OF Rrdt11$E-) L..c - e1 Cis
ON 6 / 1 g , 2010, BEFORE ME, /"v`d '1
A NOTARY PUBLIC,
PERSONALLY APPEARED S, n:d•V , WHO PROVED TO ME ON THE BASIS
OF SATISFACTORY EVIDENCE TO BE THE PERSON(S) WHOSE NAME(S IS / AitE-SUBSCRIBED TO THE
WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT -HE- SHED THEY -EXECUTED THE SAME IN -1-16-74
HEj THEIR AUTHORIZED CAPACITY(IES), AND THAT BY -1415 / ER •TI4EIR SIGNATURE 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 STATE OF CALIFORNIA THAT THE
FOREGOING PARAGRAPH IS TRUE AND CORRECT.
OriGcA'•-
r✓
WITNESS MY HAND AND SEAL:
SIGNATURE
NOTARY PUBLIC IN AND FOR SAID STATE
MY COMMISSION EXPIRES 3
MY COMMISSION NUMBER •2-G901 c C2
ANDREW HOLZ8AUR
NOTARY PURUC - CALIFORNIA
COMMISSION # 2099062 e
LOS ANGELES C 5.
A1V Comm. Exp. March 5: 20i9�
MY PRINCIPAL PLACE OF BUSINESS IS IN Lo l" ^ < COUNTY.
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 VALIDITY OF THAT DOCUMENT.
ON "% 'f 1 , 20AP, BEFORE ME, ...4.7c6Ite)d A NOTARY PUBLIC,
PERSONALLY APPEARED QIO141 ' +i-�'y - , WHO PROVED TO ME ON THE BASIS
OF SATISFACTORY EVIDENCE TO BE THE PERSON(S) WHOSE NAME(S) I5 / ARE SUBSCRIBED TO THE
WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT HE / SHE / THEY EXECUTED THE SAME IN HIS /
HER / THEIR AUTHORIZED CAPACITY(IES), AND THAT BY HIS / HER / THEIR SIGNATURE ON THE
INSTRUMENT, THE PERSON(S) OR THE ENTITY UPON BEHALF OF WHICH THE PERSON(S) ACTED,
EXECUTED THE INSTRUMENT.
aptacor)
I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF C -A weRNIA THAT THE
FOREGOING PARAGRAPH IS TRUE AND CORRECT.
WITNESS MY HAND AND SEAL:
SIGNATURE
NOTARY PUBLIC IN AND FOR SAID STATE
MY COMMISSION EXPIRES moi' )d' IS
MY COMMISSION NUMBER "t 26)
MY PRINCIPAL PLACE OF BUSINESS IS IN
a2snolq73
OFFICIAL STAMP
AARON
ARYPusuc.a ar+Fi6LD
COMMISSIONCOROSSO EXPIRESRAINY 10, 2418
COUNTY.
STATE OFMIII•Pd}A) S.S
COUNTY OF R1 E )
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 VALIDITY OF THAT DOCUMENT.
ON '7'1 1 , 20 j BEFORE ME, Clikki7trbifeld A NOTARY PUBLIC,
PERSONALLY APPEARED , 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 CAPACITY(IES), AND THAT BY HIS / HER / THEIR SIGNATURE 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 STATE OF GikLiftrIVA THAT THE
FOREGOING PARAGRAPH IS TRUE AND CORRECT.
WITNESS MY HAND AND SEAL:
SIGNATURE
r
11)
NOTARY PUBLIC IN A FOR SAID STATE
MY COMMISSION EXPIREl23
MY COMMISSION NUMBER I05
MY PRINCIPAL PLACE OF BUSINESS IS IN
COUNTY.
ApS
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 July 19, 2016 before me, SUSAN MAYSELS, Notary Public, personally
appeared TIMOTHY R. JONASSON 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 and official seal.
Signature
SUSAN MAYSELS
Commission • 2017258 Z
Notary Public - California
Riverside County
My Comm Expires Apr 13. 2017
(seal)
DOCUMENT:
QUITCLAIM DEED LLA 2016-0001 re: APN 770-170-013 and 777-170-014
— owner(s): Peter S. Borden, Jennifer S. Borden, David Silvey and Krista
Silvey
EXHIBIT "A"
LEGAL DESCRIPTION
LOT LINE ADJUSTMENT 2016-0001
PARCEL "A"
That certain parcel of land located in the City of La Quinta, County of Riverside, State of California, being
that portion of Lot 325 of Amended Tract No. 29894-2, as shown by a map on file in Book 327, Pages 56
through 88 inclusive of Maps, Records of said county, more particularly described as follows:
BEGINNING at the northeast corner of said Lot 325;
Thence South 12°44'23" West a distance of 19.16 feet;
Thence South 08°19'26" West a distance of 54.94 feet to a point on the easterly line of said Lot 325;
Thence at right angles to said line North 80°32'06" West a distance of 2.06 feet;
Thence South 08°20'00" West a distance of 104.45 feet to the southeast corner of said Lot 325, said
point being located on a non -tangent curve, concave northerly, having a radius of 232.37 feet, a radial
line of said curve bears North 07°42'03" East from said point;
Thence westerly along said southerly line of Lot 325 and said curve through a central angle of 53°31'12"
an arc distance of 217.06 feet to the southwest corner of said Lot 325;
Thence along the westerly line of said Lot 325 North 64°10'10" East a distance of 185.27 feet to the
northwest corner of said Lot 325, said point being located on a non -tangent curve concave northerly,
having a radius of 52.00 feet, a radial line bears North 57°08'21" East from said point;
Thence easterly along the northerly line of said Lot 325 and said curve through a central angle of
47°40'27" an arc distance of 43.27 feet to the POINT OF BEGINNING.
CONTAINING: 23,504.7 Square Feet, more or less.
SUBJECT TO all Covenants, Rights, Rights -of -Way and Easements of record.
Graphically depicted on 'EXHIBIT "B" — PLAT', attached hereto and by this reference made a part
hereof.
Page 1 of 2
PARCEL "B"
That certain parcel of land located in the City of La Quinta, County of Riverside, State of California, Lot
326 together with a portion of Lot 325 of Amended Tract No. 29894-2, as shown by a map on file in
Book 327, Pages 56 through 88 inclusive of Maps, Records of said county, more particularly described as
follows:
BEGINNING at the northeast corner of said Lot 325;
Thence South 12°44'23" West a distance of 19.16 feet;
Thence South 08°19'26" West a distance of 54.94 feet to a point on the easterly line of said Lot 325;
Thence at right angles to said line North 80°32'06" West a distance of 2.06 feet;
Thence South 08°20'00" West a distance of 104.45 feet to the southeast corner of said Lot 325, said
point being located on a non -tangent curve, concave northerly, having a radius of 232.37 feet, a radial
line of said curve bears North 07°42'03" East from said point;
Thence easterly along the southerly line of said Lot 326 and along said curve through a central angle of
53°36'02" an arc distance of 217.39 feet to the southeast corner of said Lot 326;
Thence along the easterly line of said Lot 326 North 45°14'22" West a distance of 173.49 feet to the
northeast corner of said Lot 326, said point being located on a non -tangent radial curve, concave
northerly, having a radius 52.00 feet;
Thence westerly along the northerly line of said Lot 326 and along said curve through a central angle of
54°42'16" an arc distance of 49.65 feet to the POINT OF BEGINNING.
CONTAINING: 23,592.1 Square Feet, more or less.
SUBJECT TO all Covenants, Rights, Rights -of -Way and Easements of record.
Graphically depicted on 'EXHIBIT "B" — PLAT', attached hereto and by this reference made a part
hereof.
This legal description and accompanying plat
were prepared by me or under my direction.
Benja►xtfn Daniel Egan, PLS 8756
Prepared: March 2, 2016
Page 2 of 2
EXHIBIT "B" - PLAT
() DENOTES RECORD DATA
PER AMENDED TRACT NO.
29894-2 (MB 276/56-88)
ADJUSTED LOT LINE
SO8°20'004 104.45'
(N09°27'54"E (R)
-17
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S12°44 X23,.W
19. 16'
S05419' 6"W
178.48')
LOT LINE TO BE DELETED
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Air SCALE: 1"=40'
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PARCEL AND 2
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LOT LINE ADJ. 2016-0001
PREPARED BY:
BEN AMIN DANIEL EGAN, PLS
SHEET 1 OF 1. LS 8756 DATE: 3/2/2016
PETER ALDANA
COUNTY OF RIVERSIDE
ASSESSOR -COUNTY CLERK -RECORDER
DOCUMENTARY TRANSFER TAX AFFIDAVIT
WARNING
ANY PERSON WHO MAKES ANY MATERIAL MISREPRESENTATION OF FACT FOR 771E 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 RIVERSIDE AND IS SUBJECT TO PROSECUTION FOR SUCII OFFENSE.
Recorder
P.O. Box 751
Riverside, CA 92502-0751
(951)486-7000
Website: www.riversideacr.com
ASSESSOR'S PARCEL NO. 777 —170 --014 I declare that the documentary transfer tax for this
Property Address: 5i ?9L \i t, C:1+1.14-1600 transaction is: $n on
LP CZt1 t►aT(k ► CA q ��
If this transaction is exempt from . Documentary Transfer Tax, the reason must be identified below.
I CLAIM THAT THIS TRANSACTION IS EXEMPT FROM DOCUMENTARY TRANSFER TAX BECAUSE: (The
Sections listed below are taken from the Revenue and Taxation Code with the exception of items 9 and 10 which are taken
from Riverside County Ordinance 516). Please check one or explain in "Other':
1. & Section 11911.
2. Section 11911.
3. Section
4. Section
5. Section
11921.
11922.
11925.
6. Section 11926.
7. Section 11927.
8. Section 11930.
9. Section 8.
10. Section 9.
11. x Other
The consideration or value of the property, exclusive of any liens and encumbrances is
$100.00 or less and there is no additional consideration received by the grantor.
The conveyance transfers to a revocable living trust by the grantor or from a revocable living
trust to a beneficiary.
The conveyance was given to secure a debt.
The conveyance is to a governmental entity or political subdivision.
The transfer is between individuals and a legal entity or partnership, or between
legal entities and does not change the proportional interests held.
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.
The conveyance relates to a dissolution of marriage or legal separation.
(A spouse must sign a written recital in order to claim this exemption. This fonn may be used for that purpose.)
The conveyance is an inter vivos gift* or a transfer by death.
*Please be aware that information stated on this document may be given to and used by governmental
agencies, including the Internal 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 Form709 (Federal Gift Tax Return) with the Internal Revenue Service.
The easement is nillperpetual, permanent, or for life.
The document is a lease for a term of j,than (35) years (including written options.)
(Include explanation and legal authority) Lot 1 ine Adjustment- Change of Property
-Line_Legal Discription _ -_
1 DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
7 day of 3I,t_U1 ,20.lo at t,i48 t NN C19.fc
State
Signature of Aninnt � Printed Name of Affiant � �J
y3 77 s. - l.�a>d c.),) �' G,Je f 2„Q(Z
Name of Firm (if applicable) Address of Affiant (including City, State, and Zip Code) G 7 #)Q
So3 - (0 3 r
Executed this
Telephone Number of Affiant (including area code)
This form is subject to the California Public Records Act (Government Code 6250 et. seq.)
For Recorder's Use:
Affix PCOR Label Here
• ACR 521 (Rev. 11/2014) Available in Alternate Formats
BOE -502-A (P1) REV. 12 (05-13)
PRELIMINARY CHANGE OF OWNERSHIP REPORT
To be completed by the transferee (buyer) prior to a transfer of subject
property, in accordance with section 480.3 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 the
property is located.
NAME AND MAIUNG ADDRESS OF BUYER/TRANSFEREE
(Make necessary concoctions lo The pdnied name and mailing address)
r
L
PETER ALOANA, COUNTY OF RIVERSIDE
ASSESSOR - COUNTY CLERK - RECORDER
PO BOX 751, RIVERSIDE, CA 92502-0751
(951) 955-0400 www.riversldeacr.com
ASSESSORS PARCEL NUMBER
777-170-014
SE LER/TRANSFEROR
David & Krista Silvey
BUYERS DAYTIME TELEPHONE NUMBER
( 310) 218-6029
BUYER'S EMAIL ADDRESS
pjborden@verizon.net
STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY
53824 Via Bellagio, La Quinta, CA 92253
MAIL PROPERTY TAX INFORMATION TO (NAME)
David & Krista Silvey
ADDRESS CITY
24397 S.W. Valley View Road West Linn
OYES NO This property is intended as my principal residence. If YES, please indicate the date of occupancy
or intended occupancy.
MO
STATE ZIP CODE
Or 97068
DAY YEAR
PART 1. TRANSFER INFORMATION Please complete all statements.
This section contains possible exclusions from reassessment for certain types of transfers.
YES NO
❑✓ A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
® B. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition or removal of
a partner, death of a partner, termination settlement, etc.).
❑ L`' . *C. This is a transfer: ❑ between parent(s) and child(ren) ❑ from grandparent(s) to grandchild(ren).
❑✓ * D. This transfer is the result of a cotenant's death. Date of death
❑ * E. This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county? OYES L NO
❑✓
*F. This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code
section 69.5. Within the same county? ❑ YES ❑ NO
L 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 lender's 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:
❑ 0 J. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
K. This is a transfer of property:
1. to/from a revocable trust that may be revoked by the transferor and is for the benefit of
❑ the transferor, and/or ❑ the transferor's spouse ❑ registered domestic partner.
✓❑ 2. to/from a trust that may be revoked by the creator/grantor/trustor who is also a joint tenant, and which
names the other joint tenant(s) as beneficiaries when the creator/grantor/trustor dies.
❑ 3. to/from an irrevocable trust for the benefit of the
❑ creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantors/trustors registered domestic partner.
❑ Li L. This property is subject to a lease with a remaining lease term of 35 years or more including written options.
— Q M. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel
being transferred remain exactly the same after the transfer.
❑ ❑✓ N. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
❑ * O. This transfer is to the first purchaser of a new building containing an active solar energy system.
* Please refer to the instructions for Part 1.
Please provide any other information that will help the Assessor understand the nature of the transfer.
❑ 0
❑ C
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
BOE -502-A (P2) REV. 12 (05-13)
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 or 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:
Original term in years (including written options): Remaining term in years (including written options):
Other. Please explain: ■ l L "'
C. Only a partial interest in the property was transferred. DYES ❑ NO
If YES, indicate the percentage transferred:
PART 3. PURCHASE PRICE AND TERMS OF SALE Check and complete as applicable.
A. Total purchase price
B. Cash down payment or value of trade or exchange excluding closing costs
C. First deed of trust @ % interest for years. Monthly payment $ Amount $ 0.00
❑ FHA (_Discount Points) ❑ Cal -Vet ❑ VA ( Discount Points) ❑ Fixed rate ^ Variable rate
I Bank/Savings & Loan/Credit Union ❑ Loan carried by seller
❑ Balloon payment $ Due date:
D. Second deed of trust @ % Interest for years. Monthly payment $
❑ Fixed rate Variable rate ❑ Bank/Savings & Loan/Credit Union ❑ Loan carried by seller
❑ Balloon payment $ Due date:
E. Was an Improvement Bond or other public financing assumed by the buyer? OYES ❑ NO Outstanding balance $ 0.00
F. Amount, if any, of real estate commission fees paid by the buyer which are not included in the purchase price $ 0.00
G. The property was purchased: EIThrough real estate broker. Broker name: Phone number: (
❑ Direct from seller ❑ From a family member -Relationship
❑ 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.
$ 0.00
Amount $ 0.00
Amount $ 0.00
PART 4. PROPERTY INFORMATION Check and complete as applicable.
A. Type of property transferred
❑ Single-family residence ❑ Co-op/Own-your-own ❑ Manufactured home
❑ Multiple -family residence. Number of units: ❑ Condominium ❑ Unimproved lot
❑/ Other. Description: (i.e., timber, mineral, water rights, etc.) ❑ Timeshare ❑ Commercial/Industrial
Portion of Land
B. DYES ❑ NO Personal/business 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 of incentives are club memberships, etc. Attach list if available.
If YES, enter the value of the personal/business property: $ Incentives
C. OYES ✓❑ NO A manufactured home is included in the purchase price.
If YES, enter the value attributed to the manufactured home: $
OYES ID NO The manufactured home is subject to local property tax. If NO, enter decal number:
D. [DYES C NO The property produces rental or other income.
If YES, the income is from: ❑ Lease/rent ❑ Contract ❑ Mineral rights Other.
E. The condition of the property at the time of sale was: [Good ❑Average ❑Fair ❑Poor
Please describe:
CERTIFICATION
I certify (or declare) 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.
1111*
8 NATURE 0 - f REE OR CORPORA T DATE , (TELEPHONE_,,e 38 c -
NAME 0r':UY-'/TTRR- SFEREEiL▪ EGAT-REPResENTATIVE RPOR E a C R (PLEASE PRINT) TITLE_/ EMAILADDRES
}er 3o rder\ 3?nn c :o rt e pjbor IlevKIn2o n,t
The Assessor's office may contact you for additional information regarding this transaction.
BOE -502-A (P3) REV. 12 (05-13)
ADDITIONAL INFORMATION
Please answer all questions in each section, and sign and complete the certification before filing. This form may be used in all 58 Califomia
counties. If a document evidencing a change in ownership is presented to the Recorder for recordation without the concurrent filing of a
Preliminary Change of Ownership Report, the Recorder may charge an additional recording fee of twenty dollars ($20).
NOTICE: The property which you acquired may be subject to a supplemental assessment in an amount to be determined by the County
Assessor. Supplemental assessments are not paid by the title or escrow company at close of escrow, and are not included in lender
impound accounts. You may be responsible for the current or upcoming property taxes even If you do not receive the tax bill.
NAME AND MAILING ADDRESS OF BUYER: Please make necessary corrections to the printed name and mailing address. Enter
Assessor's Parcel Number, name of seller, buyer's daytime telephone number, buyer's email address, and street address or physical
location of the real property.
NOTE: Your telephone number and/or email address is veru important. If there is a question or a problem, the Assessor needs
to be able to contact you.
MAIL PROPERTY TAX INFORMATION TO: Enter the name, address, city, state, and zip code where property tax information should be
mailed. This must be a valid mailing address.
PRINCIPAL RESIDENCE: To help you determine your principal residence, consider (1) where you are registered to vote, (2) the home
address on your automobile registration, and (3) where you normally return after work. If after considering these criteria you are still
uncertain, choose the place at which you have spent the major portion of your time this year. Check YES if the property is intended as
your principal residence, and indicate the date of occupancy or intended occupancy.
PART 1: TRANSFER INFORMATION
If you check YES to any of these statements, the Assessor may ask for supporting documentation.
C,D,E, F: If you checked YES to any of these statements, you may qualify for a property tax reassessment exclusion, which may allow you
to maintain your property's previous tax base. A claim form must be filed and all requirements met in order to obtain any of these
exclusions. Contact the Assessor for claim forms. NOTE: If you give someone money or property during your life, you may be subject
to federal gift tax. You make a gift if you give property (including money), the use of property, or the right to receive income from property
without expecting to receive something of at least equal value in return. The transferor (donor) may be required to file Form 709, Federal
Gift Tax Retum, with the Internal Revenue Service if they make gifts in excess of the annual exclusion amount.
G: Check YES if the reason for recording is to correct a name already on title [e.g., Mary Jones, who acquired title as Mary J. Smith, is
granting to Mary Jones]. This is not for use when a name is being removed from title.
H: Check YES if the change involves a lender, who holds title for security purposes on a loan, and who has no other beneficial interest
in the property.
"Beneficial interest" is the right to enjoy all the benefits of property ownership. Those benefits include the right to use, sell,
mortgage, or lease the property to another. A beneficial interest can be held by the beneficiary of a trust, while legal control of the
trust is held by the trustee.
I: A "cosigner" is a third party to a mortgage/loan who provides a guarantee that a loan will be repaid. The cosigner signs an agreement
with the lender stating that if the borrower fails to repay the loan, the cosigner will assume legal liability for it.
M: This is primarily for use when the transfer is into, out of, or between legal entities such as partnerships, corporations, or limited liability
companies. Check YES only if the interest held in each and every parcel being transferred remains exactly the same.
N: Check YES only if property is subject to subsidized low-income housing requirements with governmentally imposed restrictions;
property may qualify for a restricted valuation method (i.e., may result in lower taxes).
0: If you checked YES, you may qualify for a new construction property tax exclusion. A claim form must be filed and all requirements
met in order to obtain the exclusion. Contact the Assessor for a claim form.
PART 2: OTHER TRANSFER INFORMATION
A: The date of recording is rebuttably presumed to be the date of transfer. If you believe the date of transfer was a different date (e.g., the
transfer was by an unrecorded contract, or a lease identifies a specific start date), put the date you believe is the correct transfer date. If
it is not the date of recording, the Assessor may ask you for supporting documentation.
B: Check the box that corresponds to the type of transfer. If OTHER is checked, please provide a detailed description. Attach a separate
sheet if necessary.
BOE -502-A (P4) REV. 12 (05-13)
PART 3: PURCHASE PRICE AND TERMS OF SALE
It is important to complete this section completely and accurately. The reported purchase price and terms of sale are important factors in
determining the assessed value of the property, which is used to calculate your property tax bill. Your failure to provide any required or
requested information may result in an inaccurate assessment of the property and in an overpayment or underpayment of taxes.
A. Enter the total purchase price, not including closing costs or mortgage insurance.
"Mortgage Insurance" is insurance protecting a lender against loss from a mortgagor's default, issued by the FHA or a private
mortgage insurer.
B. Enter the amount of the down payment, whether paid in cash or by an exchange. If through an exchange, exclude the closing costs.
"Closing costs" are fees and expenses, over and above the price of the property, incurred by the buyer and/or seller, which
include title searches, lawyer's fees, survey charges, and document recording fees.
C. Enter the amount of the First Deed of Trust, if any. Check all the applicable boxes, and complete the information requested.
A "balloon payment" is the final installment of a loan to be paid in an amount that is disproportionately larger than the regular
installment.
D. Enter the amount of the Second Deed of Trust, if any. Check all the applicable boxes, and complete the information requested.
E. If there was an assumption of an improvement bond or other public financing with a remaining balance, enter the outstanding balance,
and mark the applicable box.
An "improvement bond or other public financing" is a lien against real property due to property -specific improvement
financing, such as green or solar construction financing, assessment district bonds, Mello -Roos (a form of financing that can be
used by cities, counties and special districts to finance major improvements and services within the particular district) or general
improvement bonds, etc. Amounts for repayment of contractual assessments are included with the annual property tax bill.
F. Enter the amount of any real estate commission fees paid by the buyer which are not included in the purchase price.
G. If the property was purchased through a real estate broker, check that box and enter the broker's name and phone number. If the
property was purchased directly from the seller (who is not a family member of one of the parties purchasing the property), check the
"Direct from seller" box. If the property was purchased directly from a member of your family, or a family member of one of the parties who
is purchasing the property, check the "From a family member" box and indicate the relationship of the family member (e.g., father, aunt,
cousin, etc.). If the property was purchased by some other means (e.g., over the Internet, at auction, etc.), check the "OTHER" box and
provide a detailed description (attach a separate sheet if necessary).
H. Describe any special terms (e.g., seller retains an unrecorded life estate in a portion of the property, etc.), seller concessions (e.g.,
seller agrees to replace roof, seller agrees to certain interior finish work, etc.), broker/agent fees waived (e.g., fees waived by the
broker/agent for either the buyer or seller), financing, buyer paid commissions, and any other information that will assist the Assessor in
determining the value of the property.
PART 4: PROPERTY INFORMATION
A. Indicate the property type or property right transferred. Property rights may include water, timber, mineral rights, etc.
B. Check YES if personal, business property or incentives are included in the purchase price in Part 3. Examples of personal or business
property are furniture, farm equipment, machinery, etc. Examples of incentives are club memberships (golf, health, etc.), ski lift tickets,
homeowners' dues, etc. Attach a list of items and their purchase price allocation. An adjustment will not be made if a detailed list is not
provided.
C. Check YES if a manufactured home or homes are included in the purchase price. Indicate the purchase price directly attributable
to each of the manufactured homes. If the manufactured home is registered through the Department of Motor Vehicles in lieu of being
subject to property taxes, check NO and enter the decal number.
D. Check YES if the property was purchased or acquired with the intent to rent or lease it out to generate income, and indicate the source
of that anticipated income. Check NO if the property will not generate income, or was purchased with the intent of being owner -occupied.
E. Provide your opinion of the condition of the property at the time of purchase. If the property is in `fair" or "poor" condition, include a
brief description of repair needed.