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Henry C. and Johnda J. Goodman
137 Butternut Lane
Ashland, KY. 41102
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CITY OF LA QUINTA
PO Box 1504
La Quinta, CA 92247
Attn : Clerk's Dept.
DOC # 2012-0500313
10/19/2012 09:05A Fee:31.00
Page 1 of 3
Recorded in Official Records
County of Riverside
Larry W. Ward
Assessor, County Clerk & Recorder
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APN 774-204-027 & 028 GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $ �U
11 computed on fitll value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale.
❑ unincorporated area ,City of La Quinta , AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged
NAME Henry C. Goodman and Johnda J. Goodman
hereby GRANT(s) to
NAME Henry C. Goodman and Johnda J. Goodman
the following described real property in the County of Riverside, State of California:
SEE ATTACHED EXHIBITS "A" & "B"
NOTE: This grant deed reflects Parcel Merger No. 2011514 as approved by the City of La Ouinta.
COMMONWEA TH OF KENTUCKY
COUNTY OF —.ba fA
On Y rrj before me, _ _jj;, / l;�t,.i' S.e.$)CJ
personally appeared J e.-,. _ , 1�
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 [ •� 1`
he./she/they executed the same in his/her/their authorized capacity(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. Joh,1�4a . Govdman\\—)
1 cer!iF ::rider PENALTY TY OF PERJURY under the laws of the State of California
that the foregoing paragraph is true and correct.
E=KENTUCKY-
EL SPEAKS
WITNESS my hand and official seal. ate at Large
ry ID # 424398s August 14. 2014
Signature (Seal)
EXHIBIT "A"
CERTIFICATE OF PARCEL MERGER 2012-514
PARCEL A
PARCELS 1 AND 2 OF PARCEL MAP 33991 AS SHOWN MAP ON FILE IN
PARCEL MAP BOOK 227, PAGES 29 AND 30, RECORDS OF RIVERSIDE
COUNTY, STATE OF CALIFORNIA, IN THE CITY OF LA QUINTA.
SAID MERGED PARCEL CONTAINING 19,992 SQUARE FEET, (0.46 ACRES)
MORE OR LESS.
ATTACHED HERETO AND MADE A PART OF THIS LEGAL DESCRIPTION, IS A
PLAT LABELED EXHIBIT "B".
SUBJECT TO ALL COVENANTS, RIGHTS, RIGHTS OF WAYS AND EASEMENTS
OF RECORD, IF ANY.
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D:WASURVEY\7083.006\dwg\PAR- xi
MERG 2011-514.docx Page 1 of 1 DAL LEH LS 6687
EXHIBIT "B"
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NOTE: % o 0 19,992 SF
DATA SHOWN RECORD PER Q Z m 5'PUE I z
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IN PARCEL MAP BOOK 227, 'fl
PAGES 29 & 30. 30' �`►��I °��
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LEGEND
EXISTING LOT LINE
------- LOT LINE TO BE ABANDONED PER SCALE 1 "=40'
THIS PARCEL MERGER
BOUNDARY OF PARCEL A OF 11
PARCEL MERGER No. 2012-514 C 20 40 80 120
PARCEL MERGER 2012-E14
MDAIRnn nn MM � /�/� nn �fj�a PREPARED BY: LAND
WEEIR LM�L�=JL!✓L ON9 ,G�PE KEL(F�'�G��a
78-080 CALLS AM/GO, SUITE 102 •.
LA CUINTA, CA 92253 NO. 6687
760 2I9-9886
dale@kellehermapping.com OAS K yI;R, DAP'�� sl'G
LS 6687 EXP. 6-30-I2 �� OF CAI-\�
LARRY W. WARD Recorder
P.O. Box 751
COUNTY OF RIVERSIDE Riverside, CA 92502-0751
�r s
ASSESSOR -COUNTY CLERK -RECORDER (951) 486-7000
Website: wwwAversideacr.com
DOCUMENTARY TRANSFER TAX AFFIDAVIT
WARNING
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.I declare that the documentary transfer tax for this
Property Address: transaction is: $ 00, p�
If this transaction is exempt from Documentary Transfer Tax, the reason must be identified below.
I CLAIM THAT THIS TRANSACTIONIS EXEMPT FROMDOCUMENTARY TRANSFER TAX BECAUSE. (The
Sections listed below are taken from the Revenue and Taxation Code. Please check one or explain in "Other".)
1
2
3
4
5
6.
7.
8.
9.
Section 11911. The document is a lease for a term of Ethan thirty-five (35) years (including options).
_ Section 11911. The easement is LQt perpetual, permanent, or for life.
_ Section 11921. The instrument was given to secure a debt.
_ Section 11922. The conveyance is to a governmental entity or political subdivision.
Section 11925. The transfer is between individuals and a legal entity, or between legal entities,
and does not change the proportional interests held.
` Section 11926. The instrument is from a trustor to a beneficiary, in lieu of foreclosure, and no
additional consideration was paid.
Section 11926. The grantee is the foreclosing beneficiary and the consideration paid by the
foreclosing beneficiary does not exceed the unpaid debt.
_ Section 11927. The conveyance relates to a dissolution of marriage or legal separation.
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.
Section 11930. The conveyance is to the grantor's revocable living trust.
Other (Include explanation and authority) S Q !7 7 (� (/ d 1? 7C) pp
I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Executed this _A day of 15t�PTWqBJE�k, .20 1 Z--at � ��jffh -- CA
City state
5: -lsr- ted Name of Affiant
8 v fT&-R/v UT LA
Name of Firm (if applicable) Address ofAffiant (inclu 'ng City State, and Zip Code)
q a a - 51�-R.3
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 (Pi) 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 4Bo.3 of the Revenue and Taxation Code. A Preliminary
Change of Ownership Report must be Tiled 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 fling. 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.
V
STREETADDRJIESS OR PHYS11CAL LOCATION OF REAL PROPERTY
S -PI�G&L _t� _!5
ASSESSOR'S PARCEL NUMBER
BUYER'S DAYTIME TELEPHONE NUMBER
g
MAIL P/ROOPPER79TAX INFORMATION O (NAME)
DDPESS
A�� CITY TE ZIP CODE
la
�ES ❑ NO This property is intended as my principal residence. If YES, please indicate the date of occupancy Mo DAY YEAR I
or intended occupancy.
PART 1. TRANSFER INFORMATION Please complete all statements.
YES NO
❑ F I 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.).
E] * C. This is a transfer between: ❑ parent(s) and children) ❑grandparent(s) and grandchild(ren).
❑ * D. This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county? []YES ❑ NO
❑ * E. This transaction is to replace a principal residence by a erson who is severely disabled as defined by Revenue and Taxation Code
section 69.5. Within the same county? ❑ YES �NO
❑ M 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:
❑
E
G. The recorded document creates, terminates, or reconveys a lender's interest in the property.
❑
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:
❑
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 be by
VI
may revoked 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/trustordies.
1. l
®
3. to/from an irrevocable trust for the benefit of the
❑ creatodgrantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantor's/trustor's registered domestic partner.
❑
�]f
4. to/from an irrevocable trust from which the property reverts to the creator/grantor/trustor within 12 years.
❑
®
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.
❑ L' M. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
❑ �] * 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 INFORMATION Check and complete as applicable.
A. Date of transfer, if other than recording date:
B. Type of transfer:
F] 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:
F] Sale/leaseback ❑ Creation of a lease Assignment of a lease n Termination of a lease. Date lease began:
Original term in years (including written options): Remaining term in years (including written options):
Other. Please explain: ( AIC cP*RW j4
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 or acquisition price. Do not include closing costs or mortgage insurance. 0c) ,
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: Phone number:
Direct from seller From a family member
Other. Please explain:
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 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 l7nimproved I❑
Other. Description: (i.e., timber, mineral, water rights, etc.) Timeshare Commercial/Industri
B. DYES N 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 personal/business property: $
C. 0 YES W NO A manufactured home is included in the purchase price.
If YES, enter the value attributed to the manufactured home: $
YES 21 NO The manufactured home is subject to local property tax. If NO, enter decal number:
D. ❑YES [S 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 11Average ❑ Fair Poor
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
everybuyerltransfe
c1 AT1r-
I-q-/2-
�tdv�
The Assessors office may contact you for additional information regarding this transaction.
] OFFICE -USE []PiLY �j
r
iy of Ld Quinta Case No. rL ❑) L ' 1
° Planning Department. Da�teRaNwd z► -
i 78-495 Cal.le 'Tampico Related Apps-
jLa Quinta, California 92253 . Logged in by:
apt.
I PHONE-060) 77777125 FAX:•777-1233
APPLICATION FOR PARCEL MERGER APPROVAL
PARCEL MERGER applications are reviewed and approved by the Planning Director pursuarit to Chapter 13.36 of
the Subdivision Regulations. The purpose is to allow merger of contiguous parcels or units of real property, under
common ownership.
e.--.*. 0.''t e.-ev + 4., a .- + 00 -''.0.-.0 e.- --e
I APPLICANT HENRY C.. GOODMAN & JOHNDA J . GOODMAN
(print)
MAILING ADDRESS 137 BUTTERNUT LANE Phone No. (606) 922-5823
CITY, STATE, ZIP: ASHLAND, kY 41102 Fax No (606) 324-6291
PROPERTY OWNER (Ifdifferent):- SAME AS ABOVE
MAILING ADDRESS
CIVY, STATE, ZIP:
MERGER LOCATION:
Assessor Parcel Number
of Parcels to be Merged:.
I
APPLICAB LITY:
(Print)
Phonic No.
Fax No.
54060+/— AVENIDA OBREGON
Parce'll 774 _204 027
Parcel 2 7 7 4_ 2 0 4 _ 0:2 8
Parcel _ -
Parcel4 - -
(Attach additional sheets, if necessary)
Merger maybe processed if the following requirement is satisfied:
❑ At least one of the affected parcels is undeveloped by any structure for which a buildingperrnit was issued or
for which a building permit was not required at the time of construction, or is developed only with an
accessory structure or accessory structures, or is developed with a single structure, other than an accessory
structure, that is also partially sited on a contiguous -parcel or unit.
MApplicationsTarcel Merger Approval.doc
F � 2 2 2012
CVfY OF LA.QUI ETA
FIMANCE [3EVr
CRITERIA FOR APPROVAL:
To obtain approval of a merger, the following criteria shall be met:
L C1 The merger complies with the standards specified in Section above.
U The parcel will be consistent with the zoning of the.
property.
11 The parcel will not conflict with the location of existing structures on the property.
Q The parcel will not be -deprived of adequate access as a result of the merg&.
0 Access to adjoining properties will not be restricted as a result of the inqrger.
C1 No new lot lines are'cr6ated by the merger.
MINMMSUBMISS ION REOUIREMENTS:
Q .'Existing grant deeds or doe reports for all affected parcels.
Q New, original, unrecorded Grant Deeds for each resulting parcel with. the following:
11 Correct legal description of the merged parcel and the statement, "This Grant Deed reflects Parcel
Merger No. as approved the City of La QWnta.."
-- - ------- LJ- Completed Certificate of Parcel Merger.No.' "Exhibit A"
0 Completed Certificate of Parcel Merger No. 'Exhibit B" - Plat showing merged parcels
LJ Completed Site.Plan, showing merger parcels and existing structures and improvements; if -any.
U If metes and bounds legal. description is Used for merged parcels, closing calculations shall -be
submitted.
El Filing fee for Parcel. Merger. If filing multiple applications, the most expensive application will be
charged
arged fLffl fee, with remaining related ap is as iscounted 50% for each.
0 + & 0 1 +
4. ev 4- 0# ;0 & . . *.*
4. e.+ V 4.+ ee 1t V1 V V I. V
SIGNATURE OF APPLICANT 4 DATE 7, -.15 )2--
I
NAME OF APPLICANT
HENRY
6*iNK+L4KLikW-F-K4_-W-EK+*- 4--
-A IF440T.&AME DATE
NAME OFOWNER JOHNDA J. GOODMAN
(Please print)
(Separate written authority by owner to submit applicqtion may be submitted)
NOTE: FALSE OR MISLEADING INFORMATION GIVEN IN THIS APPLICATION SHALL BE
GROUNDS .FOR DENYING APPLICATION.
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