MONTEREY COUNTY COO_______________________ A/O_____________ INI________ (ASSESSOR'S USE ONLY) STEPHEN L. VAGNINI, ASSESSOR P. O. BOX 570 SALINAS CA 93902 (831)755-5035 (FROM MONTEREY 647-7719) AFFIDAVIT OF ENTITY TRANSFER The purpose of this form is to provide evidence to support an exclusion from reassessment, for a transfer involving legal entities , where the proportional interests of the transferors and transferees are the same before and after the transfer. Assessor's Parcel Number(s) ________________________________________________________________ Date Recorded_____________________________ Document Number ______________________________ A. Transferor (grantor)_____________________________________________________________________ Transferor is a (circle one) CORPORATION PARTNERSHIP LLC INDIVIDUAL(S) If transferor is a corporation, partnership or LLC, list each individual owner and per cent of ownership. Owner % Owned Owner ______________________________________ ______________________________________ ______________________________________ % Owned ___________ ___________ ___________ __________________________________ _______ __________________________________ _______ __________________________________ _______ B. Transferee (grantee) _____________________________________________________________________ Transferee is a (circle one) CORPORATION PARTNERSHIP LLC INDIVIDUAL(S) If transferee is a corporation, partnership or LLC, list each individual owner and per cent of ownership. Owner % Owned Owner ______________________________________ ______________________________________ ______________________________________ % Owned ___________ ___________ ___________ __________________________________ _______ __________________________________ _______ __________________________________ _______ THE UNDERSIGNED DECLARES 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, CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. THIS FORM IS NOT SUBJECT TO PUBLIC INSPECTION. The Assessor's Office may ask for additional documentation or evidence to support the above information. _______________________________________ ______________________________ Signature of Partner, Officer or Authorized Agent Title _________________ Date _______________________________________________________________ _________________________ Name of Legal Entity Phone Entstmt 1/03 American LegalNet, Inc. www.FormsWorkFlow.com