Deceased Property Owner Change in Ownership Statement (R&T Code Sections 60-66 and 480-485) Upon completion, mail this form to the Sonoma County Assessor. Instructions: Complete a separate form for each property. Answer each question. Name of Decedent: APN: Social Security No: Date of Death : Situs: Transferee Information: A. Transfer is to decedent’s spouse or to a Trust of which the spouse is the sole beneficiary or the income beneficiary. (Check even if Affidavit of Death of Joint Tenant is to be recorded.) Name of Spouse: ____________________________________________________________ B. Transfer is to decedent’s non-spousal beneficiaries as indicated below: Name of Beneficiary Relationship to Deceased % To Be Acquired ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ This property has been sold or will be sold prior to distribution: Yes ________ No __________ Tax statements regarding reassessment should be sent to: (Name, Address & Phone #) __________________________________________________________________________________ Person to contact for additional information, during normal business hours: (Name & Phone #) __________________________________________________________________________________ Signature: _____________________________________________ Date___________________ THIS FORM DOES NOT TRANSFER TITLE. It is for assessment purposes only. Before our office can change a name of record, a document must be recorded in the Sonoma County Recorder’s Office. You may wish to consult an attorney or title company for information on the correct procedures and forms. If decedent owed property in Sonoma County that is not included in this correspondence, please list. SCAO 346 E 11-04 American LegalNet, Inc. www.USCourtForms.com