COUNTY OF SAN JOAQUIN ASSESSOR – RECORDER - COUNTY CLERK AFFIDAVIT OF EXEMPTION FROM DOCUMENTARY TRANSFER TAX THIS FORM MUST BE COMPLETED IN FULL AND FILED WITH THE DOCUMENT AT THE TIME OF RECORDING NOTICE: ANY MISREPRESENTATION OF FACT IN THIS AFFIDAVIT IS A MISDEMEANOR UNDER SECTION 1116 OF THE REAL PROPERTY TRANSFER TAX ORDINANCE. ANY PERSON WHO MAKES SUCH A MISREPRESENTATION IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE. THE RECORDER RESERVES THE RIGHT TO REPORT POTENTIALLY FRAUDULENT RECORDINGS TO THE DISTRICT ATTORNEY’S REAL ESTATE FRAUD UNIT. DATE OF RECORDING ____________ ASSESSOR’S PARCEL NUMBER(S) ___________________________ STREET ADDRESS(ES) __________________________________________________________________________ 1. THIS IS A GIFT IN WHICH NO CONSIDERATION WAS PAID OR GIVEN TO THE GRANTOR*. _____Yes ____ No *Be aware that certain gifts in excess of $13,000 per calendar year may trigger a Federal Gift Tax. In such cases, the Transferor (donor/grantor) may be required to file Form 709 (Federal Gift Tax Return) with the Internal Revenue Service. Also be aware that information stated on this document may be given and used by governmental agencies, including the Internal Revenue Service. I, as the Transferor (Donor/Grantor), declare under penalty of perjury that I have read the above paragraph and acknowledge that a Federal Gift Tax may be triggered. _______________________________________________ Donor Signature _________________________ Donor Phone Number 2. THIS IS A FORECLOSURE OR A TRUSTEE SALE. ____ YES ____NO IF YES, IS THE TRANSFEREE THE BENEFICIARY OR MORTGAGEE? ____YES ____ NO 3. THIS IS SOLELY THE ADDITION/DELETION OF A COSIGNER WHO HAS/HAD NO OWNERSHIP INTEREST IN THE PROPERTY. ____ YES ____ NO IF YES, LIST THE NAME OF THE CO-SIGNER ________________________________ COMPLETE AND ATTACH THE CO-SIGNER AFFIDAVIT. 4. THIS IS A LEASE WITH A TERM, INCLUDING OPTIONS, OF LESS THAN 35 YEARS. ____ YES ____ NO IF YES, WHAT IS THE TERM INCLUDING ALL OPTIONS? _____________ 5. THE PROPERTY WAS CONVEYED BY AN EXECUTOR/ADMINISTRATOR IN ACCORDANCE WITH AN ESTATE. ____ YES ____ NO American LegalNet, Inc. www.FormsWorkFlow.com COUNTY OF SAN JOAQUIN ASSESSOR – RECORDER - COUNTY CLERK 6. THIS TRANSFER WAS BETWEEN AN INDIVIDUAL OR INDIVIDUALS AND A LEGAL ENTITY OR BETWEEN LEGAL ENTITIES, AND THE PROPORTIONAL OWNERSHIP INTERESTS IN THE REALTY REMAIN EXACTLY THE SAME. ____ YES ____ NO IF YES, PROVIDE THE OWNERS AND PERCENTAGES BOTH BEFORE AND AFTER THIS TRANSFER. OWNERS INCLUDE SHAREHOLDERS, MEMBERS, AND PARTNERS. 7. THIS IS A CORRECTION DOCUMENT ONLY. ____ YES ____ NO ORIGINAL RECORDING DATE _____________ ORIGINAL DOCUMENT NUMBER _________________ REASON FOR CORRECTION _______________________________________________________________ 8. OTHER ___________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ I DECLARE OR AFFIRM UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. ______________________________________________________ SIGNATURE _________________________________________ PRINT NAME _____________________________________________________________________________________________________________________ ADDRESS _________________________________________________________________ PHONE NUMBER ____ TRANSFEREE _________________________________________________________________ PLACE OF EXECUTION (CITY, COUNTY, STATE) _____________________________________________ DATE OF EXECUTION SAN JOAQUIN COUNTY RECORDER 44 N. SAN JOAQUIN STREET SUITE 260 STOCKTON CA 95202 PHONE: (209) 468-3939 FAX: (209) 468-8040 EMAIL: recorder@sjgov.org www.sjgov.org/recorder ____ TRANSFEROR MAILING ADDRESS: SAN JOAQUIN COUNTY RECORDER PO BOX 1968 STOCKTON CA 95201 American LegalNet, Inc. www.FormsWorkFlow.com