From The Office of
SAM DUCA, Assessor City and County of San Francisco. Room 101, City Hall.
San Francisco, California 94102
CHANGE IN OWNERSHIP STATEMENT
REAL PROPERTY OR MOBILE HOMES SUBJECT TO
LOCAL PROPERTY TAXES
Correct mailing address if necessary
Name and Address of Buyer/Transferee (Last name, first name(s), initial)
Γ
FOR INFORMATION CALL:
RECORDING DATA
VOLUME
Date
Document No.,
Book
Page
ASSESSOR’S IDENTIFICATION NUMBER
BLOCK
LOT
Property Address
PLEASE ENCLOSE A COPY OF REAL ESTATE CLOSING STATEMENT Legal Description.
Seller/Transferor,
(Lest name, first namefal, initial)
IMPORTANT NOTICE
SECTION 480 OF THE CALIFORNIA REVENUE AND TAXATION CODE REQUIRES ANY TRANSFEREE ACQUIRING AN INTEREST IN REAL PROPERTY OR MOBILEHOME SUBJECT TO LOCAL PROPERTY TAXATION TO FILE A CHANGE IN OWNERSHIP STATEMENT WITH THE COUNTY RECORDER OR ASSESSOR. THE CHANGE IN OWNER- SHIP STATEMENT MUST BE FILED AT THE TIME OF RECORDING OR, IF THE TRANSFER IS NOT RECORDED, WITHIN 45 DAYS OF THE DATE OF THE CHANGE IN OWNERSHIP. THE FAILURE TO FILE A CHANGE IN OWNER- SHIP STATEMENT WITHIN 45 DAYS FROM THE DATE OF A WRITTEN REQUEST BY THE ASSESSOR RESULTS IN A PENALTY OF ONE HUNDRED DOLLARS ($100) OR 10 PERCENT OF THE CURRENT YEAR’S TAXES ON THE REAL PROPERTY OR MOBILEHOME, WHICHEVER IS GREATER. THIS PENALTY WILL BE ADDED TO THE ROLL AND SHALL BE TREATED AND COLLECTED LIKE, AND SHALL BE SUBJECT TO THE SAME PENALTIES FOR DELIN- QUENCY AS, ALL OTHER TAXES ON THE ROLL ON WHICH IT IS ENTERED.
This notice is a written request from the Office of Assessor for a Change in Ownership Statement. Failure to file this statement results in the assessment of a penalty. This statement will be held secret as required by Section 481 of the Revenue and Taxation Code.
A REAL PROPERTY CHANGE IN OWNERSHIP TRANSFER INFORMATION. Check (v) all appropriate boxes “YES” or “NO” to indicate the method by which you acquired an interest in the property.
YES NO
YES NO
- O
9.
PURCHASE
LAND SALES CONTRACT a contract for the purchase of property in whiche seller retains legal title to it after the buyer rakes possession.
Was this transaction only a correction of the names of the personis) holding title to the property?
10.
If you hold title to this property as a joint tenant, is the seller or transferor also a joint tenant?
INHERITANCE Transfer by will or as required if no will. Date of Death
11.
12.
Was this transaction the termination of a joint tenancy interest? Was this a transfer between family members or related businesses?
Relationship to Deceased
O
TRADE OR EXCHANGE – The above described property hos been traded or exchanged for other real property or tangible
13.
or intangible personal property.
5.LEASE WITH A TERM OF 35 YEARS OR MORE – Creation,
6.
7.
DO
assignment, or termination of a lease or sublease with a term of 35 years or more (including renewal options).
MERGER OR STOCK ACQUISITION
16.
PARTIAL INTEREST TRANSFER was any a partial interest in The property transferred? YES indicare ine percentage
16b.
Transferred. - Was this transier asiely between husband and wife. addition of a spouse, death of a spouse, divorce settlement,
etc.)
Was this document recorded to substitute a trustee under a deed of trust, mortgage, or other similar document?
Was this document recorded to create, assign, or terminate a lander’s interest in this property?
Has this property been transferred to a trust? If “YES” is the Irrevocable
trust
Revocable
If the trust is irrevocable, is the transferor or the transferor’s spouse a present beneficiary?
Does this property revert to the transferor in 12 years or less? Clifford Trust
If you have answered “YES” to 150 or 6b, attach a copy of the trust agreement to this statement.
PLEASE COMPLETE THE REVERSE SIDE
ENCLOSE A COPY OF REAL ESTATE CLOSING STATEMENT
38E-450 AM 502 FRONT 7-2-0 REVISED 9:30-80
In response to the above referenced application for a policy of title insurance. Title Company hereby reports that it is prepared to issue, or cause to be issued, as of the date hereof, a Policy or Policies of Title Insurance describing the land and the estate or interest therein hereinafter set forth, insuring against loss which may be sustained by reason of any defect, lien or encumbrance not shown or referred to as an Exception below or not excluded from coverage pursuant to the printed Schedules, Conditions and Stipulations of said policy forms.
The printed Exceptions and Exclusions from the coverage of said Policy or Policies are set forth in Schedule I and Schedule I (continued) attached. Copies of the Policy forms should be read. They are available from the office which issued this
report.
This report (and any supplements or amendments hereto) is issued solely for the purpose of facilitating the issuance of policy of title insurance and no liability is assumed hereby. If it is desired that liability be assumed prior to the issuance of a policy of title insurance, a Binder or Commitment should be requested.