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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 n r D S12°44 X23,.W 19. 16' S05419' 6"W 178.48') LOT LINE TO BE DELETED Na D crin N rn rn LAJ ilj Imo; Cv\> Air SCALE: 1"=40' a co n a r rq O O 0 -A 0 co O PARCEL AND 2 C/L VIA BELL GA IO -\ - CO tw W 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.