Form Boe 502 Ah – Fill Out and Use This PDF

The law requires any transferee acquiring an interest in real property or manufactured home subject to local property taxation, and that is assessed by the county assessor, to ile a Change in Ownership Statement with the County Recorder or Assessor. The Change in Ownership Statement must be iled at the time of recording or, if the transfer is not recorded, within 90 days of the date of the change in ownership, except that where the change in ownership has occurred by reason of death the statement shall be iled within 150 days after the date of death or, if the estate is probated, shall be iled at the time the inventory and appraisal is iled. The failure to ile a Change in Ownership Statement within 90 days from the date of a written request by the Assessor results in a penalty of either: (1) one hundred dollars ($100); or (2) 10 percent of the taxes applicable to the new base year value relecting the change in ownership of the real property or manufactured home, whichever is greater, but not to exceed ive thousand dollars ($5,000) if the property is eligible for the homeowners’ exemption or twenty thousand dollars ($20,000) if the property is not eligible for the homeowners’ exemption if that failure to ile was not willful. This penalty will be added to the assessment roll and shall be collected like any other delinquent property taxes, and be subject to the same penalties for nonpayment.

SELLER/TRANSFEROR

ASSESSOR'S PARCEL NUMBER

BUYER/TRANSFEREE

BUYER’S DAYTIME TELEPHONE NUMBER

(

)

STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY

MAIL PROPERTY TAX INFORMATION TO (NAME)

ADDRESS

CITY

STATE

ZIP CODE

YES

NO

This property is intended as my principal residence. If YES, please indicate the date of occupancy

MO

DAY

YEAR

or intended occupancy.

PART 1. TRANSFER INFORMATION Please complete all statements.

YES NO

A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.).

B. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition or removal of

a partner, death of a partner, termination settlement, etc.).

* C. This is a transfer between:

parent(s) and child(ren)

grandparent(s) and grandchild(ren).

*D. This transaction is to replace a principal residence by a person 55 years of age or older.

Within the same county? YES NO

*E. This transaction is to replace a principal residence by a person who is severely disabled as deined by Revenue and Taxation Code

section 69.5. Within the same county?NOYES

F.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).

If YES, please explain:

G. The recorded document creates, terminates, or reconveys a lender's interest in the property.

H.This transaction is recorded only as a requirement for inancing purposes or to create, terminate, or reconvey a security interest (e.g., cosigner). If YES, please explain:

I. The recorded document substitutes a trustee of a trust, mortgage, or other similar document.

J. This is a transfer of property:

1. to/from a revocable trust that may be revoked by the transferor and is for the beneit of

the transferor, and/or

the transferor's spouse

registered domestic partner.

2.to/from a trust that may be revoked by the creator/grantor/trustor who is also a joint tenant, and which names the other joint tenant(s) as beneiciaries when the creator/grantor/trustor dies.

3. to/from an irrevocable trust for the beneit of the

creator/grantor/trustor and/or grantor's/trustor’s spouse grantor’s/trustor’s registered domestic partner. 4. to/from an irrevocable trust from which the property reverts to the creator/grantor/trustor within 12 years.

K. This property is subject to a lease with a remaining lease term of 35 years or more including written options.

L.This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel being transferred remain exactly the same after the transfer.

M. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions. * N. This transfer is to the irst purchaser of a new building containing an active solar energy system.

*If you checked YES to statements C, D, or E, you may qualify for a property tax reassessment exclusion, which may allow you to maintain your previous tax base. If you checked YES to statement N, you may qualify for a property tax new construction exclusion. A claim form must be iled and all requirements met in order to obtain any of these exclusions. Contact the Assessor for claim forms.

Please provide any other information that will help the Assessor understand the nature of the transfer.

THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION

South County Toll Free (800) 660-7725

www.acgov.org/assessor

BOE-502-AH (P2) REV. 14 (11-11)
PART 2. OTHER TRANSFER INFORMATION	Check and complete as applicable.

A.Date of transfer, if other than recording date:

B.Type of transfer:

Purchase

Foreclosure

Gift

Trade or exchange

Merger, stock, or partnership acquisition (Form BOE-100-B)

Contract of sale. Date of contract:

Inheritance. Date of death:

Sale/leaseback

Creation of a lease

Assignment of a lease

Termination of a lease. Date lease began:

Remaining term in years (including written options):

Original term in years (including written options):

Down payment:			$			Interest rate:	%		Seller-paid points or closing costs: $
									Balloon payment: $
		Loan carried by seller				Assumption of Contractual Assessment* with a remaining balance of: $

* An assessment used to inance property-speciic improvements that constitutes a lien against the real property.

B. The property was purchased:		Through real estate broker. Broker name:		Phone number: (		)
Direct from seller	From a family member

Other. Please explain:

C.Please explain any special terms, seller concessions, inancing, and any other information (e.g., buyer assumed the existing loan balance) that would assist the Assessor in the valuation of your property.

CERTIFICATION

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any accompanying statements or documents, is true and correct to the best of my knowledge and belief. This declaration is binding on each and every buyer/transferee.

SIGNATURE OF BUYER/TRANSFEREE OR CORPORATE OFFICER	DATE
t
NAME OF BUYER/TRANSFEREE/LEGAL REPRESENTATIVE/CORPORATE OFFICER (PLEASE PRINT)	TITLE
E-MAIL ADDRESS

The Assessor’s ofice may contact you for additional information regarding this transaction.