B0E-502-A (FRONT) REV.

8 (10-05)

FOR RECORDER'S USE ONLY

WEBSTER J. GUILLORY ORANGE COUNTY ASSESSOR (714) 834-5031 PRELIMINARY CHANGE OF OWNERSHIP REPORT
[To be completed by transferee [buyer] prior to transfer of subject property in accordance with section 480.3 of the Revenue and Taxation Code.] A Preliminary Change of Ownership Report must be filed with each conveyance in the County Recorders office for the county where the property is located; this particular form may be used in all 58 counties of California. THIS REPORT IS NOT A PUBLIC DOCUMENT SELLER/TRANSFEROR: BUYER/TRANSFEREE: ASSESSOR'S PARCEL NUMBER(S): PROPERTY ADDRESS OR LOCATION: MAIL TAX INFORMATION TO: Name Address ( ) Phone Number (8 a.m.-5 p.m.)____________________________

NOTICE: A lien for property taxes applies to your property on January 1 of each year for the taxes owing in the following fiscal year, July 1 through June 30. One-half of these taxes is due November 1, and one-half is due February 1. The first installment becomes delinquent on December 10, and the second installment becomes delinquent on April 10. One tax bill is mailed before November 1 to the owner of record. You may be responsible for the current or upcoming property taxes even if you do not receive the tax bill.

The property which you acquired may be subject to a supplemental assessment in an amount to be determined by the Orange County Assessor. For further information on your supplemental roll obligation, please call the Orange County Assessor at (714) 834-2941. PART I: TRANSFER INFORMATION (please answer all questions)
YES NO

A. Is this transfer solely between husband and wife (addition of a spouse, death of a spouse, divorce settlement, etc.)? B. Is this transaction only a correction of the name(s) of the person(s) holding title to the property (for example, a name change upon marriage)? Please explain___________________________________________________________________ C. Is this document recorded to create, terminate, or reconvey a lender's interest in the property? D. Is this transaction recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest (e.g., cosigner)? Please explain___________________________________________________________________ E. Is this document recorded to substitute a trustee of a trust, mortgage, or other similar document? F. Did this transfer result in the creation of a joint tenancy in which the seller (transferor) remains as one of the joint tenants? G. Does this transfer return property to the person who created the joint tenancy (original transferor)? H. Is this a transfer of property: 1. to a revocable trust that may be revoked by the transferor and is for the benefit of the transferor transferors spouse? 2. to a trust that may be revoked by the Creator/Grantor who is also a joint tenant, and which names the other joint tenant(s) as beneficiaries when the Creator/Grantor dies? 3. to an irrevocable trust for the benefit of the Creator/Grantor and/or Grantors spouse? 4. to an irrevocable trust from which the property reverts to the Creator/Grantor within 12 years? I. If this property is subject to a lease, is the remaining lease term 35 years or more including written options? * J. Is this a transfer between parent(s) and child(ren)? or from grandparent(s) to grandchild(ren)? * K. Is this transaction to replace a principal residence by a person 55 years of age or older? Within the same county? Yes No * L. Is this transaction to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code section 69.5? Within the same county? Yes No M. Is this transfer solely between domestic partners currently registered with the California Secretary of State? *If you checked yes to J, K or L, you may qualify for a property tax reassessment exclusion, which may result in lower taxes on your property. If you do not file a claim, your property will be reassessed. Please provide any other information that will help the Assessor to understand the nature of the transfer. If the conveying document constitutes an exclusion from a change in ownership as defined in section 62 of the Revenue and Taxation Code for any reason other than those listed above, set forth the specific exclusions claimed: ____________________________________. Please answer all questions in each section. If a question does not apply, indicate with N/A. Sign and date at bottom of second page. A. B. PART II: OTHER TRANSFER INFORMATION Date of transfer if other than recording date _______________________________ Type of transfer (please check appropriate box) : Purchase Foreclosure Gift Trade or Exchange Merger, Stock, or Partnership Acquisition Contract of Sale Date of Contract __________________________________ Inheritance Date of Death _________________ Other (please explain) : ______________________________________ Creation of Lease Assignment of a Lease Termination of a Lease Sale/Leaseback Date lease began ______________________________ Original term in years (including written options) ____________________________ Remaining term in years (including written options) ___________________________ Monthly Payment___________________________________ Remaining Term_______________________________________ Was only a partial interest in the property transferred? Yes No If yes, indicate the percentage transferred ___________________%.

C.

A002-213 (R10/05)

BOE-502-A (BACK) REV. 8 (10-05)

Please answer, to the best of your knowledge, all applicable questions, then sign and date. If a question does not apply, indicate with "N/A." PART III: PURCHASE PRICE AND TERMS OF SALE A. CASH DOWN PAYMENT OR value of trade or exchange (excluding closing costs) Amount $ ___________ B. FIRST DEED OF TRUST @ _______% interest for ______ years. Pymts./Mo.=$______ (Prin. & Int. only) Amount $ ___________ FHA (_____Discount Points) Fixed rate New loan Conventional Variable rate Assumed existing loan balance VA (_______Discount Points) All inclusive D.T. ($___________Wrapped) Bank or savings & loan Cal-Vet Loan carried by seller Finance company Balloon payment Yes No Due Date_________________ Amount $_______________ C. SECOND DEED OF TRUST @ _______% interest for ______ years. Pymts./Mo.=$______ (Prin. & Int. only) Amount $ ___________ Bank or savings & loan Fixed rate New loan Loan carried by seller Variable rate Assumed existing loan balance Balloon payment Yes No Due Date_________________ Amount $_______________ D. OTHER FINANCING: Is other financing involved not covered in (b) or (c) above? Yes No Amount $ ___________ Type __________________@ _______% interest for ______ years. Pymts./Mo.=$______ (Prin. & Int. only) Bank or savings & loan Fixed rate New loan Loan carried by seller Variable rate Assumed existing loan balance Balloon payment Yes No Due Date_________________ Amount $_______________ E. WAS AN IMPROVEMENT BOND ASSUMED BY THE BUYER? Yes No Outstanding Balance: Amount $ ______________ F. TOTAL PURCHASE PRICE (or acquisition price, if traded or exchanged, include real estate commission if paid) TOTAL ITEMS A THROUGH E $ G. PROPERTY PURCHASED Through a broker Direct from seller From a family member Other (please explain): _____ . If purchased through a broker, provide broker's name and phone number: ________________________________________________ Please explain any special terms, seller concessions, or financing and any other information that would help the Assessor understand the purchase price and terms of sale: _____________________________________________________________________________ PART IV: PROPERTY INFORMATION A. TYPE OF PROPERTY TRANSFERRED: Single-family residence Agricultural Timeshare Multiple-family residence (no. of units: ___________) Co-op/Own-your-own Manufactured Home Commercial/Industrial Condominium Unimproved lot Other (Description: i.e., timber, mineral, water rights, etc.__________________________________________________________) B. IS THIS PROPERTY INTENDED AS YOUR PRINCIPAL RESIDENCE? Yes No If yes, enter date of occupancy ___________/_________, 20______ or intended occupancy ___________/_________, 20______.
(month) (day) (year) (month) (day) (year)

C. IS PERSONAL PROPERTY INCLUDED IN PURCHASE PRICE (i.e., furniture, farm equipment, machinery, etc.) (other than a manufactured home subject to local property tax)? Yes No If yes, enter the value of the personal property included in the purchase price $___________ (Attach itemized list of personal property.) D. IS A MANUFACTURED HOME INCLUDED IN PURCHASE PRICE? Yes No If yes, how much of the purchase price is allocated to the manufactured home? $__________________________________________ Is the manufactured home subject to local property tax? Yes No What is the decal number?_____________________ E. DOES THE PROPERTY PRODUCE INCOME? Yes No If yes, is the income from: Lease/Rent Contract Mineral rights Other (please explain):____________________________ F. WHAT WAS THE CONDITION OF THE PROPERTY AT THE TIME OF SALE? Good Average Fair Poor Please explain the physical condition of the property and provide any other information (such as restrictions, etc.) that would assist the Assessor in determining the value of the property: _______________________________________________________________________________________________________ CERTIFICATION
OWNERSHIP TYPE () Proprietorship Partnership Corporation Other______________

I certify that the foregoing is true, correct and complete to the best of my knowledge and belief. This declaration is binding on each and every co-owner and/or partner.
TITLE

NAME OF NEW OWNER/CORPORATE OFFICER

SIGNATURE OF NEW OWNER/CORPORATE OFFICER

DATE

NAME OF ENTITY (typed or printed)

FEDERAL EMPLOYER ID NUMBER

ADDRESS (typed or printed)

E-MAIL ADDRESS (OPTIONAL)

DATE

(NOTE: The Assessor may contact you for additional information.) If a document evidencing a change of ownership is presented to the recorder for recordation without the concurrent filing of a preliminary change of ownership report, the recorder may charge an additional recording fee of twenty dollars ($20).