BOE-502-A (P1) REV. 12 (05-13) PRELIMINARY CHANGE OF OWNERSHIP REPORT To be completed by the transferee (buyer) prior to a transfer of subject property,inaccordancewithsection480.3oftheRevenueandTaxation Code.APreliminary Change of Ownership Reportmustbefiledwitheach conveyance in the County Recorder's office for the county where the property is located. SACRAMENTO COUNTY ASSESSOR Property Transfer Section 3701 Power Inn Road, Suite 3000 Sacramento CA 95826-4329 (916) 875-0750 NAMEANDMAILINGADDRESSOFBUYER/TRANSFEREE (Make necessary corrections to the printed name and mailing address) ASSESSOR'SPARCELNUMBER SELLER/TRANSFEROR BUYER'SDAYTIMETELEPHONENUMBER ( STREETADDRESSORPHYSICALLOCATIONOFREALPROPERTY MAILPROPERTYTAXINFORMATIONTO(NAME) ADDRESS ) BUYER'SEMAILADDRESS CITY MO STATE ZIPCODE DAY YEAR YES NO Thispropertyisintendedasmyprincipalresidence.IfYES,pleaseindicatethedateofoccupancy orintendedoccupancy. PART 1. TRANSFER INFORMATION Please complete all statements. Thissectioncontainspossibleexclusionsfromreassessmentforcertaintypesoftransfers. YES NO A. Thistransferissolelybetweenspouses(addition or removal of a spouse, death of a spouse, divorce settlement, etc.). B. ThistransferissolelybetweendomesticpartnerscurrentlyregisteredwiththeCaliforniaSecretaryofState(addition or removal of a partner, death of a partner, termination settlement, etc.). * C. Thisisatransfer: between parent(s) and child(ren) from grandparent(s) to grandchild(ren). * D. Thistransferistheresultofacotenant'sdeath.Dateofdeath___________________________ * E. This transaction is to replace a principal residence by a person 55 years of age or older. Withinthesamecounty? YES NO * F. ThistransactionistoreplaceaprincipalresidencebyapersonwhoisseverelydisabledasdefinedbyRevenueandTaxationCode section69.5.Withinthesamecounty? YES NO G. This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage). IfYES,pleaseexplain: H. Therecordeddocumentcreates,terminates,orreconveysalender'sinterestintheproperty. I. Thistransactionisrecordedonlyasarequirementforfinancingpurposesortocreate,terminate,orreconveyasecurityinterest (e.g., cosigner).IfYES,pleaseexplain: J. Therecordeddocumentsubstitutesatrusteeofatrust,mortgage,orothersimilardocument. K. Thisisatransferofproperty: 1. to/fromarevocabletrustthatmayberevokedbythetransferorandisforthebenefitof thetransferor,and/or thetransferor'sspouse registereddomesticpartner. 2. to/fromatrustthatmayberevokedbythecreator/grantor/trustorwhoisalsoajointtenant,andwhich namestheotherjointtenant(s)asbeneficiarieswhenthecreator/grantor/trustordies. 3. to/fromanirrevocabletrustforthebenefitofthe creator/grantor/trustorand/or grantor's/trustor'sspouse grantor's/trustor'sregistereddomesticpartner. L. Thispropertyissubjecttoaleasewitharemainingleasetermof35yearsormoreincludingwrittenoptions. M. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel beingtransferredremainexactlythesameafterthetransfer. N. Thisisatransfersubjecttosubsidizedlow-incomehousingrequirementswithgovernmentallyimposedrestrictions. * O.Thistransferistothefirstpurchaserofanewbuildingcontaininganactivesolarenergysystem. * PleaserefertotheinstructionsforPart1. Please provide any other information that will help the Assessor understand the nature of the transfer. THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION American LegalNet, Inc. www.FormsWorkFlow.com BOE-502-A (P2) REV. 12 (05-13) PART 2. OTHER TRANSFER INFORMATION A. Dateoftransfer,ifotherthanrecordingdate: B. Typeoftransfer: Purchase Foreclosure Gift Tradeorexchange Check and complete as applicable. Merger,stock,orpartnershipacquisition(FormBOE-100-B) Inheritance.Dateofdeath: Contractofsale.Dateofcontract: Sale/leaseback Creationofalease Assignment of a lease Original term in years (including written options): Other.Pleaseexplain: C. Onlyapartialinterestinthepropertywastransferred. A. Totalpurchaseprice YES NO Terminationofalease.Dateleasebegan: Remaining term in years (including written options): IfYES,indicatethepercentagetransferred: % PART 3. PURCHASE PRICE AND TERMS OF SALE Check and complete as applicable. $_______________ Amount$_______________ Amount$_______________ Variable rate Fixedrate B. Cashdownpaymentorvalueoftradeorexchangeexcludingclosingcosts C. Firstdeedoftrust@______%interestfor______years.Monthlypayment$_____________ FHA(___DiscountPoints) Cal-Vet VA(___DiscountPoints) Loancarriedbyseller Bank/Savings&Loan/CreditUnion Balloonpayment$_____________ Duedate:_____________ D. Seconddeedoftrust@______%interestfor______years.Monthlypayment$_____________ Fixedrate Variable rate Bank/Savings&Loan/CreditUnion Duedate:_____________ YES Loancarriedbyseller Balloonpayment$_____________ Amount$_______________ E. WasanImprovementBondorotherpublicfinancingassumedbythebuyer? G.Thepropertywaspurchased: Direct from seller Other.Pleaseexplain: Throughrealestatebroker.Brokername: NO Outstandingbalance$_______________ Phonenumber: F. Amount,ifany,ofrealestatecommissionfeespaidbythebuyerwhicharenotincludedinthepurchaseprice From a family member-Relationship ( $_______________ ) H. Pleaseexplainanyspecialterms,sellerconcessions,broker/agentfeeswaived,financing,andanyotherinformation(e.g.,buyerassumedthe existingloanbalance)thatwouldassisttheAssessorinthevaluationofyourproperty. PART 4. PROPERTY INFORMATION A. Type of property transferred Single-family residence Multiple-familyresidence.Numberofunits: Other.Description:(i.e.,timber,mineral,waterrights,etc.) B. YES Check and complete as applicable. Co-op/Own-your-own Condominium Timeshare Manufacturedhome Unimprovedlot Commercial/Industrial NO Personal/businessproperty,orincentives,providedbysellertobuyerareincludedinthepurchaseprice.Examplesofpersonal propertyarefurniture,farmequipment,machinery,etc.Examplesofincentivesareclubmemberships,etc.Attachlistifavailable. $ $ Incentives $ NO Amanufacturedhomeisincludedinthepurchaseprice. NO Themanufacturedhomeissubjecttolocalpropertytax.IfNO,enterdecalnumber: NO Thepropertyproducesrentalorotherincome. Lease/rent Contract Good Mineral rights Average Other: Fair Poor IfYES,enterthevalueofthepersonal/businessproperty: C. YES YES D. YES IfYES,enterthevalueattributedtothemanufacturedhome: IfYES,theincomeisfrom: E. Theconditionofthepropertyatthetimeofsalewas: Pleasedescribe:_________________________________________________________________