This notice is a request for a completed Change in result in the assessment of a penalty. BOE-502-D (P1) REV. (-1)CHANGE IN OWNERSHIP STATEMENTDEATH OF REAL PROPERTY OWNER (Make necessary corrections to the printed name and mailing address) DESCRIPTIVE INFORMATION(IF APN UNKNOWN) Copy of deed by which decedent acquired title is attached. NO Deed or tax bill is not available; legal description is attached. TRANSFER INFORMATION Check all that apply and list details below. Claim for Reassessment Exclusion for Transfer Between Parent and Child Claim for Reassessment Exclusion for Transfer from Grandparent to Grandchild Claim for Reassessment Exclusion for Transfer Between Parent and Child if appropriate.THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTIONDISPOSITION OF REAL PROPERTY Succession without a will Probate Code 13650 distribution Decree of distribution pursuant to will to terms of a trust YESNO instructions). Section 480(b) of the Revenue and Taxation Code requires that in each county where the decedent owned property at the time of death. File a separate statement for each parcel of real property owned by the decedent. American LegalNet, Inc. www.FormsWorkFlow.com Will the decree of distribution include distribution of an ownership interest in any legal entity that owns real property YES NOYES BOE-502-D (P2) REV. (0-1) CERTIFICATIONI certify (or declare) under penalty of perjury under the laws of the State of California that the information contained herein is true, correct and complete to the best of my knowledge and belief. ( ) MAILING ADDRESS FOR FUTURE PROPERTY TAX STATEMENTS NO NO YES INSTRUCTIONSstatement is required.with the county recorder or assessor in each county in which the decedent owned an interest in real property within 150 days after the date of death. shall be "the date of death of decedent."the decedent owned property at the time of death." American LegalNet, Inc. www.FormsWorkFlow.com