LLA 2013-533 Parcel APLEASE COMPLETE THIS INFORMATION
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
CITY OF LA QUINTA
Attn: CITY CLERK DEPT
78-495 Calle Tampico
La Q.uinta, CA 92253
DOC # 2015-0260977
06/18/2015 04:32 PM Fees: $58.00
Page 1 of 12
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: MGREGSTO
SPACE ABOVE FOR RECORDER'S USE ONLY
GRANT DEED LLA 2013-533
APN 767-800-069, THE UNDERSIGNED GRANTOR(S) DECLARE(S)
APN 767-800-089, and DOCUMENTARY TRANSFER TAX IS $
APN 767-800-093 CITY TAX IS $ 0
computed on full value of property conveyed, or
computed on full value less value of liens or
encumbrances remaining at time of sale,
OUnincorporated area:F City of La Quinta
THIS AREA FOR
RECORDERS
USE ONLY
THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION
Order No.
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
City of La Quinta Public Works
78495 Calle Tampico
La Quinta, CA 92253
COPY TO:
IOTA Griffin, LLC.
c/o Sabal Financial Group, L.P.
4675 MacArthur Ct., Suite 1550
Newport Beach, CA 92260
DOCUMENTARY TRANSFER TAX$0.00 .............................................. SPACE ABOVE THIS LINE
.....Computed on the consideration or value of property conveyed; OR
.....Computed on the consideration or value less liens or encumbrances
remaining at time of sale. Signature of Declarant or Agent determining tax - Firm Name
APN: 767-800-069, 767-800-089
& 767-800-093 GRANT DEED
LLA 2013-533
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, APPROVED BY CITY OF LA QUINTA
IOTA Griffin, LLC, a California limited liability company A`—__ :72,, 0_,,,. _ . _ _
hereby GRANT(s) to Timothyiondss&, P.E.,
IOTA Griffin, LLC, a California limited liability company Public Works Director/City Engineer
the real property in the City of La Quinta
County of Riverside , State of California, described as
Parcel "A" as described and shown on Exhibits "A" and "B" attached hereto and by reference made a part hereof
NOTE: This grant deed implements the revised lot configuration to Lot Lina Adjustment 2013 -533 as approved by the City of La Quinta.
Parcel "A" of this lot line adjustment is owned by a single entity, hence ownership conveyance is a nonessential secondary function of
this deed. The primary function of this deed is to provide constructive notice of the revised lot configurations pursuant to Government
Code Section 66412 (d), and to perfect the intent of Lot Line Adjustment 2013 -533 as approved.
Dated: _ / Vc IOTA Griffin, LLC, a California Limited Liability Company
MAIL TAX STATEMENTS TO:
MAIL TAX STATEMENTS TO:
IOTA Griffin, LLC
IOTA Griffin, LLC
/o Sabal Financial Group, L.P.
675 MacArthur Ct., Suite 1550
lewport Beach, CA 92660
BY: Sabal FAaAcial Group, LP, a California Limited Partnershi
In its a ci y ' tuber of IOTA Griffin, LLC
BY-
R. Patterson Jackson
ITS: Authorized Signatory
"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 ORANGE)
On May 4, 2015, before me, Jaclyn Mary Lanning, Notary Public, personally appeared
R. Patterson Jackson, 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/sloe/they executed the same in his/her/tom authorized capacity(ies), and that
by his/her/heir signature(s) on the instrument the person(&), 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.
WITNESS my hand and official seal.
JACLYN MARY CANNING
Commission # 2062208 Z
n
z .h Notary Public - California Z
I l I '� Z orange County
Signature I At 11 i co �,�X /4F,AT,) g comm. Expires Mar 23, 2018
of wry Public
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 June 9, 2015 before me, SUSAN MAYSELS, Notary Public, personally
appeared TIMOTHY JQNASSON 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. 0 'SUSAN:Mp SE`S
Commission 2017258
Z Notary..Pubiie - California z
Riverside county
SignatureyrComm. Expires Apr 13, 2017
(seal)
DOCUMENT:
GRANT DEED LLA ,2013-533 re: APNs 767-800-069, 767-800-089, and
767-800-093 — owner(s): IOTA Griffin, LLC, a California limited liability
company
EXHIBIT "A"
LOT LINE ADJUSTMENT
NO. 2013-533
PARCEL "A":
IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF
CALIFORNIA, THOSE PORTIONS OF LOT "AL" AND LOT "AB" OF TRACT
MAP NO. 32879, AS SHOWN BY MAP ON FILE IN BOOK 399 OF MAPS, AT
PAGES 3 THROUGH 20, INCLUSIVE, RIVERSIDE COUNTY RECORDS,
ALSO BEING IN THE NORTH HALF OF SECTION 15, TOWNSHIP 6 SOUTH,
RANGE 7 EAST, SAN BERNARDINO MERIDIAN, MORE PARTICUALARLY
DESCRIBED AS FOLLOWS:
BEGINNING AT THE NORTHEAST CORNER OF SAID LOT "AL";
THENCE SOUTH 02003'12" EAST ALONG THE EASTERLY LINE OF SAID
LOT "AL", A DISTANCE OF 1716.29 FEET TO THE SOUTHEAST CORNER
THEREOF;
THENCE NORTH 87047'15" WEST ALONG THE SOUTHERLY LINE OF SAID
LOT "AL", A DISTANCE OF 31.20 FEET TO THE SOUTHWEST CORNER
THEREOF;
THENCE NORTH 02003'12" WEST ALONG THE WESTERLY LINE OF SAID
LOT "AL" AND ITS NORTHERLY PROLONGATION, A DISTANCE OF 129.62
FEET TO THE BEGINNING OF A NON -TANGENT CURVE, CONCAVE
NORTHERLY, HAVING A RADIUS OF 320.50 FEET, A RADIAL LINE TO SAID
POINT BEARS SOUTH 05°04'28" EAST;
THENCE EASTERLY ALONG THE ARC OF SAID CURVE, THROUGH A
CENTRAL ANGLE OF 05°13'51", AN ARC DISTANCE OF 29.26 FEET TO A
LINE PARALLEL WITH AND 2.00 FEET WESTERLY OF SAID EASTERLY
LINE OF LOT "AL";
THENCE NON -TANGENT TO SAID CURVE NORTH 02003'12" WEST ALONG
SAID PARALLEL LINE, A DISTANCE OF 42.19 FEET TO THE BEGINNING
OF A NON -TANGENT CURVE, CONCAVE NORTHEASTERLY, HAVING A
RADIUS OF 24.50 FEET, A RADIAL LINE TO SAID POINT BEARS SOUTH
01 °27'25" WEST;
THENCE NORTHWESTERLY ALONG THE ARC OF SAID CURVE,
THROUGH A CENTRAL ANGLE OF 86029'23", AN ARC DISTANCE OF 36.98
FEET;
THENCE NORTH 02003'12" WEST, A DISTANCE OF 102.05 FEET TO THE
BEGINNING OF A TANGENT CURVE, CONCAVE WESTERLY, HAVING A
RADIUS OF 825.50 FEET;
PAGE 1 OF 4
EXHIBIT "A"
LOT LINE ADJUSTMENT
NO.2013-533
THENCE NORTHERLY ALONG THE ARC OF SAID CURVE, THROUGH A
CENTRAL ANGLE OF 06-44-38", AN ARC DISTANCE OF 97.16 FEET TO
THE BEGINNING OF A REVERSE CURVE, CONCAVE SOUTHEASTERLY,
HAVING A RADIUS OF 24.50 FEET, A RADIAL LINE TO SAID POINT BEARS
SOUTH 81012'10" WEST;
THENCE NORTHEASTERLY ALONG THE ARC OF LAST SAID CURVE,
THROUGH A CENTRAL ANGLE OF 79022'23", AN ARC DISTANCE OF 33.94
FEET TO THE BEGINNING OF A REVERSE CURVE, CONCAVE
NORTHERLY, HAVING A RADIUS OF 220.50 FEET, A RADIAL LINE TO SAID
POINT BEARS SOUTH 19°2527" EAST;
THENCE EASTERLY ALONG THE ARC OF LAST SAID CURVE, THROUGH
A CENTRAL ANGLE OF 03012'51", AN ARC DISTANCE OF 12.37 FEET TO A
LINE PARALLEL WITH AND 2.00 FEET WESTERLY OF SAID EASTERLY
LINE OF LOT "AL";
THENCE NON -TANGENT TO SAID CURVE NORTH 02003'12" WEST ALONG
SAID PARALLEL LINE, A DISTANCE OF 44.53 FEET TO THE BEGINNING
OF A NON -TANGENT CURVE, CONCAVE NORTHWESTERLY, HAVING A
RADIUS OF 179.50 FEET, A RADIAL LINE TO SAID POINT BEARS SOUTH
27°38'31" EAST,
THENCE SOUTHWESTERLY ALONG THE ARC OF SAID CURVE,
THROUGH A CENTRAL ANGLE OF 01 °00'11 ", AN ARC DISTANCE OF 3.14
FEET TO THE BEGINNING OF A COMPOUND CURVE, CONCAVE
NORTHEASTERLY, HAVING A RADIUS OF 24.50 FEET, A RADIAL LINE TO
SAID POINT BEARS SOUTH 26038'20" EAST;
THENCE NORTHWESTERLY ALONG THE ARC OF LAST SAID CURVE,
THROUGH A CENTRAL ANGLE OF 112036'31", AN ARC DISTANCE OF
48.15 FEET TO THE BEGINNING OF A COMPOUND CURVE, CONCAVE
EASTERLY, HAVING A RADIUS OF 777.00 FEET, A RADIAL LINE TO SAID
POINT BEARS SOUTH 85058'11" WEST;
THENCE NORTHERLY ALONG THE ARC OF LAST SAID CURVE,
THROUGH A CENTRAL ANGLE OF 10041'08", AN ARC DISTANCE OF
144.91 FEET TO THE BEGINNING OF A REVERSE CURVE, CONCAVE
WESTERLY, HAVING A RADIUS OF 523.00 FEET, A RADIAL LINE TO SAID
POINT BEARS SOUTH 83°20'41" EAST;
THENCE NORTHERLY ALONG THE ARC OF LAST SAID CURVE,
THROUGH A CENTRAL ANGLE OF 08042'31", AN ARC DISTANCE OF 79.49
FEET;
PAGE 2OF4
EXHIBIT "A"
LOT LINE ADJUSTMENT
NO. 2013-533
THENCE NORTH 02003'12" WEST, A DISTANCE OF 409.46 FEET TO THE
BEGINNING OF A TANGENT CURVE, CONCAVE WESTERLY, HAVING A
RADIUS OF 523.00 FEET;
THENCE NORTHERLY ALONG THE ARC OF SAID CURVE, THROUGH A
CENTRAL ANGLE OF 10-46-50", AN ARC DISTANCE OF 98.41 FEET TO
THE BEGINNING OF A REVERSE CURVE, CONCAVE EASTERLY, HAVING
A RADIUS OF 477.00 FEET, A RADIAL LINE TO SAID POINT BEARS SOUTH
77009'58" WEST;
THENCE NORTHERLY ALONG THE ARC OF LAST SAID CURVE,
THROUGH A CENTRAL ANGLE OF 12036'47", AN ARC DISTANCE OF
105.01 FEET;
THENCE NORTH 00013-15" WEST, A DISTANCE OF 186.20 FEET TO THE
BEGINNING OF A TANGENT CURVE, CONCAVE SOUTHEASTERLY,
HAVING A RADIUS OF 24.50 FEET;
THENCE NORTHEASTERLY ALONG THE ARC OF SAID CURVE, THROUGH
A CENTRAL ANGLE OF 90°00'00", AN ARC DISTANCE OF 38.48 FEET;
THENCE NORTH 89046'45" EAST, A DISTANCE OF 9.19 FEET TO A LINE
PARALLEL WITH AND 2.00 FEET WESTERLY OF SAID EASTERLY LINE OF
LOT "AL";
THENCE NORTH 02003'12" WEST ALONG SAID PARALLEL LINE, A
DISTANCE OF 41.02 FEET;
THENCE SOUTH 89046'45" WEST, A DISTANCE OF 28.01 FEET TO THE
WESTERLY LINE OF SAID LOT "AL";
THENCE ALONG THE WESTERLY AND NORTHERLY LINES OF SAID LOT
"AL" THROUGH THE FOLLOWING THREE (3) COURSES:
(1) THENCE NORTH 02-03'12" WEST, 110.86 FEET TO THE BEGINNING OF
A TANGENT CURVE, CONCAVE SOUTHWESTERLY, HAVING A RADIUS
OF 25.00 FEET;
(2) THENCE NORTHWESTERLY ALONG THE ARC OF SAID CURVE,
THROUGH A CENTRAL ANGLE OF 88010'03", AN ARC DISTANCE OF 38.47
FEET;
(3) THENCE NORTH 89046'45" EAST, A DISTANCE OF 54.23 FEET TO THE
POINT OF BEGINNING.
PAGE 3OF4
EXHIBIT "A"
LOT LINE ADJUSTMENT
NO. 2013-533
SUBJECT TO EXISTING EASEMENTS, COVENANTS, RIGHTS AND
RIGHTS -OF -WAY OF RECORD.
ADJUSTED PARCEL "A" CONTAINING 48,521 SQUARE FEET OR 1.114
ACRES, MORE OR LESS.
EXHIBIT "B" ATTACHED HERETO AND BY THIS REFERENCE MADE A
PART HEREOF.
PREPARED BY OR UNDER THE DIRECTION OF
dmav-
CHARLES R. HARRIS P.L.S. 4989
DATED: �EXP. 12/31 /2015
/KX-ir
PAGE 4OF4
CHARLESR. HARRIS
iirA No. 4989
��
9T .
\� OF CA�F�
CITY OF LA QUINTA - CERTIFICATE OF LOT LINE ADJUSTMENT
EXHIBIT •B• - INDEX SHEET I LOT LINE ADJUSTMENT NO. 2013-533
0
- PARCEL •D•
APN 767-800-090
(PORTION)
SEE SHEET 2
81 •AR•
FLING R
WAY PRIVATE STREET
PAR. "A'
PAR. 'B'
83 84
'
PARCEL •A•
C ANT 85
1.114 AC.
COURT
APN 767-800-089
86
SEE SHEETS 2 - 4
(PRIVATE
STREET)
87
pqA�
PAR. 88
3
TqA
DRIVE—
'
PAR. 'A'
108
z
SHEET 2
R/VgTF
SHEET 3
STRe�
107
A ADM RAIL-
0' 300' 600'
RIVE—
lie 118
SCALE 1 "=300'
(PR/VA1119 ' PARCEL •B•
TE STREW AN-0 WAR 1 1.538 AC. 00L LANQ
CURT APN 767-800-093 3 t9l
1130 SEE SHEETS 2 - 4
AR. 'B � C R. y%ORRIS 0
1131 PAR. A D- /� �0
(PRIVATE ACBET No. 4989
S REET TEE
143 144 PAR. A
LEGEND
EXISTING LOT LINE TO
BE DELETED -------
EXISTING LOT LINE TO
REMAIN
NEW ADJUSTED LOT LINE
(#) INDICATES RECORD
DATA PER
MB 399/3-20 ALONG
LINES TO BE DELETED
PARCEL •C•
0.269 AC. 000,
APN 767-800-069 DATED:
SEE SHEETS 3 & 4
IDMSA CONSULTING, INC.
PLANNING ■ CIVIL ENGINEERING
LAND SURVEYING
J.N. 1721 SHEET 1 OF 4
CITY OF LA QUINTA - CERTIFICATE OF LOT LINE ADJUSTMENT
EXHIBIT •B• 1 LOT LINE ADJUSTMENT NO. 2013-533
AVENUE 54
LOT "AK"
oLOT "AR"
- a
V o WELL SITE
dCLc(n�
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L20 C23 U19 N =
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84 PAR. "B"
>
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o
LOT "AB"
w
r�
85
0
FUTURE
0
CENTERLINE -, o
P.O.B.
PAR. "A"
— PARCEL •A•
1.114 AC.
APN 767-800-089
SEE DETAIL •A•
BELOW RIGHT
2'
P.O.C.
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LOT "AC' — :I o DOC. No. 2015-0098212
01 REC. 03/12/2015, O.R.
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(PRIVATE STREET) o 1 _ 1.114 AC.
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SEE SHEET 3
SCALE 1"=100'
IDMSA CONSULTING, INC.
PLANNING ■ CIVIL ENGINEERING
LAND SURVEYING
J.N. 1 721 SHEET 2 OF 4
CITY OF LA QUINTA - CERTIFICATE OF LOT LINE ADJUSTMENT
EXHIBIT •BY LOT LINE ADJUSTMENT NO- 2013-533
N 85'58'11" E
W II
N'to II
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PARCEL °E°
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SEE DETAIL °B° I
ABOVE RIGHT
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(PRIVATE STREET LOT "Z"
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130
W'LY LINE
-II LOT "AB"
0
O
u. SEE DETAIL °C°
® AT RIGHT
cn 131
0 10' PUE
MACBETH STREET _
(PRIVATE STREET) LOT "Y"
10' PUE
�0 143 j
144PAE�CEL °C0.269 AC.
APN 767-800-0L16
PARCEL 'A® LOT LINE TO BE
1.114 AC. DELETED
APN 767-800-089
2'
l
L/C32 l
FUTURE I I
CENTERLINE I
I C6
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10' PUE p 0) N 26.38'20" W
ZI R)FUTURE
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' 20.5'
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' 12" w
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Z
MSA CONSULTING, INC.
I'LANNING ® CrvI. ENGMERING
LAND SURvEYIlVG
J.N. 1721 SHEET 3 OF 4
Sty or RIVERS
LARRY W. WARD Recorder
P.O. Box 751
COUNTY OF RIVERSIDE Riverside, CA 92502-0751
ASSESSOR -COUNTY CLEF -RECORDER (951)486-7000
Website: www.riversideacr.com
DOCUMENTARY TRANSFER TAX AFFIDAVIT
WAFTING
ANY PERSON WHO 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 RIVERSIDE AND IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE.
ASSESSOR'S PARCEL NO,767-800.069;-089;-093 I declare that the documentary transfer tax for this
Property Address: Ardennals Drive transaction is: $ 0.00
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 BECA USE. (The
Sections listed below are taken from the Revenue and Taxation Code. Please check one or explain in "Other':)
1. _ Section 11911. The document is a lease for a term of less than thirty-five (35) years (including options).
2. _ Section 11911. The easement is not perpetual, permanent, or for life.
3. _ Section 11921. The instrument 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 between legal entities,
and does not change the proportional interests held.
6. _ Section 11926. The instrument is from a trustor to a beneficiary, in lieu of foreclosure, and no
additional consideration was paid.
7. _ Section 11926. The grantee is the foreclosing beneficiary and the consideration paid by the
foreclosing beneficiary does not exceed the unpaid debt.
8. _ Section 11927. The conveyance relates to a dissolution of marriage or legal separation.
9. _ Section 11930. 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 Form 709 (Federal Gift Tax Return) with the Internal Revenue Service.
10. _ Section 11930. The conveyance is to the grantor's revocable living trust.
11. _ Other (Include explanation and authority)
IDECLARE UNDER PENALTYOFPERJURYTHAT THE FOREGOING IS TRUEAND CORRECT.
ec po this day of 20� at C-if irti-7 (� G
1 City State
L� R. Paherson Jackson
Signature of Aflia Printed Name of Afflant
IOTA Griffin, LLC 4675 MacArthur Court, Ste 1550 Newport Beach, CA 92660
Name.of Firm (if applicable) Address of Affiant (including City, State, and Zip Code)
(949) 255-2682
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. 03/2012) Available in Alternative Formats
BOE-502-A (P 1) REV. 11 (07-10)
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. Please answer all
questions in each section, and sign and complete the certification before filing. This
form may be used in all 58 California 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.
LARRY W. WARD, COUNTY OF RIVERSIDE
ASSESSOR - COUNTY CLERK - RECORDER
PO BOX 12004, RIVERSIDE, CA 92502-2204
(951) 955-6200 www.dversideacr.com
SELLER/TRANSFEROR ASSESSOR'S PARCEL NUMBER
IOTA Griffin, LLC c/o Sabal Financial Group, LP / Jim Stockhausen, Manager 767-800-069;-089;-093
BUYER/TRANSFEREE - BUYER'S DAYTIME TELEPHONE NUMBER
IOTA Griffin, LLC c/o Sabal Financial Group, LP / Jim Stockhausen, Manager (925 ) 255-2682
STREETADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY
Ardennais Drive
MAIL PROPERTY TAX INFORMATION TO (NAME)
IOTA Griffin, LLC
4675 MacArthur Court, Suite 1550
Newport Beach
CA 192660
RYES ❑✓ NO This property is intended as my principal residence. If YES, please indicate the date of occupancy MO DAY YEAR
or intended occupancy.
PART 1.
YES NO
❑ ❑✓
❑ ❑✓
TRANSFER INFORMATION Please complete all statements.
A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).
B.
❑ ❑✓ * C.
❑ ❑✓ * D.
❑ 0*E
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.).
This is a transfer between: ❑ parent(s) and child(ren) ❑grandparent(s) and grandchild(ren).
This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county? ❑ YES ❑ NO
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
❑ F. 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:
❑ ❑f G. The recorded document creates, terminates, or reconveys a lender's interest in the property.
❑ Fv(1 H. 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 I. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
J. 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.
❑
0
3. to/from an irrevocable trust for the benefit of the
❑ creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantor's/trustor's registered domestic partner.
❑
0
4. to/from an irrevocable trust from which the property reverts to the creator/grantor/trustor within 12 years.
❑ FV] K. This property is subject to a lease with a remaining lease term of 35 years or more including written options.
❑ L. 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.
❑ ❑✓ M. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
❑ FV] * N. This transfer is to the first purchaser of a new building containing an active solar energy system.
* If you checked YES to statements C, D, or E, you may qualify for a property tax reassessment exclusion, which may allow you to
maintain your previous tax base. If you checked YES to statement N, you may qualify for a property tax new construction exclusion. A
claim form must be filed and all requirements met in order to obtain any of these exclusions. Contact the Assessor for claim forms.
Please provide any other information that will help the Assessor understand the nature of the transfer
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
BOE-502-A (P2) REV. 11 (07-10)
PART 2.OTHER TRANSFER INFORI'11iATION N/A Check and complete as applicable.
A. Date of transfer, if other than recording date:
B. Type of transfer:
Purchase ❑ Foreclosure 0 Gift Trade or exchange n Merger, stock, or partnership acquisition (Form BOE-100-13)
Contract of sale. Date of contract: Q Inheritance. Date of death:
Sale/leaseback Q 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):
L ] 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 N/A Check and complete as applicable.
A. Total purchase or acquisition price. Do not include closing costs or mortgage insurance. $
Down payment: $
Interest rate: % Seller -paid points or closing costs: $
Balloon payment:
Loan carried by seller Assumption of Contractual Assessment* with a remaining balance of. $
*An assessment used to finance property -specific improvements that constitutes a lien against the real property.
B. The property was purchased: Through real estate broker. Broker name:
❑ Direct from seller ❑ From a family member
Other. Please explain:
Phone number:
C. Please explain any special terms, seller concessions, 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 N/A
A. Type of property transferred
Single-family residence
Multiple -family residence. Number of units:
Other. Description: (i.e., timber, mineral, water rights, etc.)
Check and complete as applicable.
Co-op/Own-your-own
Condominium
Timeshare
Manufactured home
Unimproved lot
Commercial/Industrial
B. ❑YES ❑ NO Personal/business property, or incentives, are included in the purchase price. Examples are furniture, farm equipment,
machinery, club memberships, etc. Attach list if available.
If YES, enter the value of the person allbusiness property: - $
C. FIYES ❑ NO A manufactured home is included in the purchase price.
If YES, enter the value attributed to the manufactured home: $
YES F1 NO The manufactured home is subject to local property tax. If NO, enter decal number:
D. YES ❑ 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 FFair FPoor
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California 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. This declaration is binding on each and
eve"ye fytransfer q
SIGNFUTEC BU SFEREE OR CORPORATE OFFICER. - DATE
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The Assessor's office may contact you for additional information regarding this transaction.