SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVESIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVEMAILING ADDRESS () BOE-58-AH (P1) REV. 1 (0-1) CLAIM FOR REASSESSMENT EXCLUSION FORTRANSFER BETWEEN PARENT AND CHILDA. PROPERTY ASSESSOR222S PARCEL NUMBERPROPERTY ADDRESS CITYRECORDER222S DOCUMENT NUMBER DATE OF PURCHASE OR TRANSFERPROBATE NUMBER (if applicable) DATE OF DEATH (if applicable) DATE OF DECREE OF DISTRIBUTION (if applicable) The disclosure of social security numbers is mandatory as required by Revenue and Taxation Code section 63.1. [See Title 42 United Service. The numbers are used by the Assessor and the state to monitor the exclusion limit. 1.Print full name(s) of transferor(s)2.Social security number(s)3.Family relationship(s) to transferee(s)If adopted, age at time of adoption4. Was this property the transferor222s principal residence? Yes NoIf yes, please check which of the following exemptions was granted or was eligible to be granted on this property: Homeowners222 Exemption Disabled Veterans222 Exemption Yes No6.Was only a partial interest in the property transferred?If yes,Assessor222s parcel number, address, date of transfer, names of all the transferees/buyers, and family relationship. Transferor222s principal Yes No If yes, percentage transferred %7.Was this property owned in joint tenancy? Yes No B. TRANSFEROR(S)/SELLER(S) (additional transferors please complete 223B224 on the reverse) 8. CERTIFICATIONDAYTIME PHONE NUMBERCITY, STATE, ZIPEMAIL ADDRESSDATEDATENAME AND MAILING ADDRESS (Make necessary corrections to the printed name and mailing address.) THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION (Please complete applicable information on reverse side.) American LegalNet, Inc. www.FormsWorkFlow.com BOE-58-AH (P2) REV. 1 (0-1) C. TRANSFEREE(S)/BUYER(S) (additional transferees please complete 223C224 below) NAME SOCIAL SECURITY NUMBER SIGNATURE RELATIONSHIPNAME RELATIONSHIPCERTIFICATION1.Print full name(s) of transferee(s) 2.Family relationship(s) to transferor(s) If adopted, age at time of adoption If stepparent/stepchild relationship is involved, was parent still married to or in a registered domestic partnership (registered meansregistered with the California Secretary of State) with stepparent on the date of purchase or transfer? Yes NoIf no, was the marriage or registered domestic partnership terminated by: Death Divorce/Termination of partnershipIf terminated by death, had the surviving stepparent remarried or entered into a registered domestic partnership as of the date of purchaseor transfer? Yes NoIf in-law relationship is involved, was the son-in-law or daughter-in-law still married to or in a registered domestic partnership with thedaughter or son on the date of purchase or transfer? Yes NoIf no, was the marriage or registered domestic partnership terminated by: Death Divorce/Termination of partnershipIf terminated by death, had the surviving son-in-law or daughter-in-law remarried or entered into a registered domestic partnership as ofthe date of purchase or transfer? Yes No3.ALLOCATION OF EXCLUSION (If the full cash value of the real property transferred exceeds the one million dollar value exclusion, thetransferee must specify on an attachment to this claim the amount and allocation of the exclusion that is being sought.)SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVEMAILING ADDRESS ( )CITY, STATE, ZIPEMAIL ADDRESSDATEDAYTIME PHONE NUMBER C. TRANSFEREE(S)/BUYER(S) (additional transferees please complete 223C224 below)3.ALLOCATION OF EXCLUSION (If the full cash value of the real property transferred exceeds the one million dollar value exclusion, thetransferee must specify on an attachment to this claim the amount and allocation of the exclusion that is being sought.)CERTIFICATION Note: The Assessor may contact you for additional information.B. ADDITIONALTRANSFEROR(S)/SELLER(S) (continued)C. ADDITIONAL TRANSFEREE(S)/BUYER(S) (continued) American LegalNet, Inc. www.FormsWorkFlow.com CLAIM FOR REASSESSMENT EXCLUSION FOR TRANSFER BETWEEN PARENT AND CHILDRevenue and Taxation Code, Section 63.1 IMPORTANT: Please note: 1. This exclusion only applies to transfers that occur on or after November 6, 1986;2. In order to qualify, the real property must be transferred from parents to their children or children to their parents;3. If you do not complete and return this form, it may result in this property being reassessed.4. 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-timethe parent-child change in ownership exclusion after two written requests have been sent to an eligible transferee by the county assessor. BOE-58-AH (P3) REV. 1 (0-1) American LegalNet, Inc. www.FormsWorkFlow.com