CLAIM OF EXEMPTION FROM DOCUMENTARY TRANSFER TAX TO: John Tuteur Napa County Recorder-County Clerk Date Recorded: Serial No. FROM: ASSESSOR'S PARCEL NO. I CLAIM THAT THE ATTACHED DOCUMENT IS EXEMPT FROM DOCUMENTARY TRANSFER TAX BECAUSE: (The Sections listed below are taken from the California Revenue and Taxation Code. Please check one or explain in "Other".) 1. ___ Section 11911. The consideration is less than $100. 2. ___ Section 11911. The document is a lease for a term of less than thirty-five (35) years. 3. ___ Section 11911. Easement is not perpetual or permanent. 4. ___ Section 11921. The document was given to secure a debt. (mortgage or deed of trust) 5. ___ Section 11922. A conveyance to a governmental entity or political subdivision. 6. ___ Section 11925. Transfers between individuals and a legal entity or between legal entities that does not change the proportional interests held. 7. ___ Section 11927. Transfer related to dissolution of marriage. 8. ___ Section 11930. Transfer by inter vivos gift or by death. 9. ___ Section 11930. Transfer to a trust by grantor or from trust to beneficiary. 10. ___ Other (Include explanation and authority) ____________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Executed this _____ day of ___________________, 20____ at _____________________________________________. City State _________________________________________ Firm Name _______________________________________________ Signature _____________________________________________________ Print Name Here 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. Rev 12-2010 American LegalNet, Inc. www.FormsWorkFlow.com