CLAIM FOR REASSESSMENT EXCLUSION FORTRANSFER FROM GRANDPARENT TO GRANDCHILD A. PROPERTYB. TRANSFEROR(S)/SELLER(S) (GRANDPARENTS)1.Print full name(s) of transferor(s) 2.Was this property the principal residence of the transferor? Yes No If yes, please check which one of the following exemptions was granted or was eligible to be granted on this property: Homeowners222 Exemption Dis abled Veterans222 Exemption3.Was real property other than the principal residence of the transferor transferred? Yes No 4.Was only a partial interest in the property transferred? Yes No If yes, percentage transfered %. 5.Did you own this property as a joint tenant? Yes N o7.Print name(s) of child(ren) of transferor(s)/seller(s) who is(are) the parent(s) of transferee(s) (grandchild): CERTIFICATION BOE-58-G (P1) REV. 1 (0-1) THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION ( ) NAME AND MAILING ADDRESS (Make necessary corrections to the printed name and mailing address.)ASSESSOR222S PARCEL NUMBERSIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVESIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVEMAILING ADDRESSCITY, STATE, ZIPEMAIL ADDRESSDAYTIME PHONE NUMBER DATEDATE PROPERTY ADDRESSRECORDER222S DOCUMENT NUMBERPROBATE NUMBER (if applicable)DATE OF PURCHASE OR TRANSFERDATE OF DEATH OF GRANDPARENT (if applicable) The disclosure of social security numbers is mandatory as required by Revenue and Taxation Code section 63.1. 6. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and any accompanying statements are true and correct to the best of my knowledge and that I am the grandparent (or their legal representative) of the transferees listed in Section C. I Code section 69.5. American LegalNet, Inc. www.FormsWorkFlow.com C. TRANSFEREE(S)/BUYER(S) (GRANDCHILD) (additional transferees please complete 223C224 below)1.Print full name(s) of transferee(s) Family relationship(s) to transferor(s) If adopted, age at time of adoption Adopted by whom? 2. Parent: Name of direct descendent of grandparent (son or daughter)Date of death of direct descendentSocial security number of direct descendent: a.Was deceased parent married or in a registered domestic partnership (registered means registered with the California Secretary ofState) as of the date of death? Yes Nob.Is the spouse or registered domestic partner of the deceased parent a (check one): Parent of the grandchild (go to question c). Stepparent of the grandchild (a stepparent to the grandchild need not be deceased in meeting the condition that 223all of the parents224 of the grandchild must be deceased) (go to question 3).c.Had surviving spouse/partner remarried or entered into a registered domestic partnership as of the date of purchase or transfer? Yes No If yes, date of marriage or registration of the domestic partnership must have occurred prior to the date of purchase or transfer to qualify for exclusion. Date of marriage/partnership registration: (Please provide marriage or partnership If no, surviving spouse/partner is still considered a child of grandparents and must also be deceased prior to the purchase or transfer to qualify for exclusion. Date of death 3.Did transferee receive a principal residence from parents? (If transferee has already received an excludable principal residence, or interesttherein, from parents, then the purchase or transfer of a principal residence from grandparents will not be excluded as a principal residence but will be applied toward the one million dollar ($1,000,000) full cash value limit exclusion of other real property received from parents.) Yes NoIf yes: County: Assessor222s Parcel Number: 4.Did transferee receive real property other than a principal residence from deceased parent who is a direct descendent ofgrandparents? (If transferee has already received an excludable principal residence, or interest therein, from parents, then the purchase or transfer of a principal residence from grandparents will not be excluded as a principal residence but will be applied toward the one million dollar ($1,000,000) full cash value limit exclusion of other real property received from deceased parents.) Yes No If yes, attach list of all previous transfers (include for each property: the county, Assessor222s parcel number, situs address, date of transfer, names of all transferees, and the family relationship). Note: CERTIFICATION I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and any accompanying statements are true and correct to the best of my knowledge and that I am the grandchild (or their legal representative) of the transferors listed in Section B. I certify that all my parents who qualify as children of my transferor grandparents are deceased as of the date of transfer or purchase, and that all BOE-58-G (P2) REV. 1 (0-1) ADDITIONAL TRANSFEREE(S)/BUYER(S) (GRANDCHILD) (continued)NAMERELATIONSHIP( )SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVEMAILING ADDRESSCITY, STATE, ZIPEMAIL ADDRESSDAYTIME PHONE NUMBERDATE American LegalNet, Inc. www.FormsWorkFlow.com CLAIM FOR REASSESSMENT EXCLUSION FOR TRANSFER BETWEEN GRANDPARENT AND GRANDCHILDRevenue and Taxation Code, Section 63.1 IMPORTANT: Sections A, B, and C and answer each question or your claim may be denied. Proof of eligibility, including a copy of the transfer document, trust, or will, may be required. 1.This exclusion only applies to transfers that occur on or after March 27, 1996;2.In order to qualify, all the parents of that grandchild must be deceased as of the date of purchase or transfer. As used in thepreceding sentence, parents are those persons who qualify under section 63.1 as children of the grandparents. However,for transfers that occur on or after January 1, 2006, a son-in-law or daughter-in-law of the grandparent that is a stepparent to thegrandchild need not be deceased in meeting the condition that 223all of the parents224 of the grandchild must be deceased.3.In order to qualify, the real property must be transferred from grandparents to their grandchildren;4.If you do not complete and return this form, it may result in this property being reassessed.5.California law provides, with certain limitations, that a 223change in ownership224 does not include the purchase or transfer of: NOTE: Effective January 1, 2009, Revenue and Taxation Code Section 63.1(j) allows a county board of supervisors to authorize a one-time a claim for the grandparent-grandchild change in ownership exclusion after two written requests have been sent to an eligible transferee by the county assessor. BOE-58-G (P3) REV. 1 (0-1) American LegalNet, Inc. www.FormsWorkFlow.com