3501 Civic Center Dr., Room 208 225 P.O. Box C 225 San Rafael, CA 94913 225 www.marincounty.org225 415.473.7215 225 FAX 415.473.6542 Documentary Transfer Tax Transmittal (Secure/Terminate Financing Only) Document Number Date of Recording Location and/or TRA Note: County Transfer Tax is $.55 per $500.00 or portion thereof, exclusive of assumed liens and encumbrances. City Transfer Tax for City of San Rafael is $2.00 per $1000 or portion thereof (in addition to applicable County tax). Total Amount of Deed of Trust $ Percentage of Property Being Transferred % Total Transfer Tax Basis $ County Tax $ City of San Rafael Tax (if applicable) $ Total Transfer Tax Due $ Any other information which may be pertinent: I declare, under penalty of perjury, that the foregoing facts are true and correct to the best of my knowledge. By Contact person Phone number American LegalNet, Inc. www.FormsWorkFlow.com