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Transfer Tax Affidavit (San Francisco) - California
| Transfer Tax Affidavit (San Francisco) Form. This is a California form and can be used in Assessor-Recorder San Francisco Local County . |
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City and County of San Francisco Office of the Assessor-Recorder FOR RECORDER'S USE ONLY Document Series Number: TRANSFER TAX AFFIDAVIT NOTICE: ANY MATERIAL 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. 1. LOCATION OF PROPERTY: Street Address Describe document(s) to be recorded: 2. IS THIS A FORECLOSURE / DEED IN LIEU OF FORECLOSURE OR A TRUSTEE SALE? (If yes, complete this section, if no, proceed to #3) a. Is the Transferee the foreclosing Beneficiary or Mortgagee b. Is the Transferee foreclosing a Senior Loan c. If no, enter the amount(s) of Senior Loan(s) and proceed to #6 $ No (If no, proceed to #4). Yes Yes No No Yes No Block Lot 3. IS THIS A LEASE? Yes (If yes, complete this section) a. Is remaining term of lease including renewal options equal or greater than 35 years? Yes (If yes, please complete #6) No (no transfer tax is due) b. If yes, submit a copy of lease or summary of its terms Consideration or Value of leasehold Interest: c. Enter amount on line 6a for tax calculation. No (If no, proceed to #5) and have the donor complete the section Name of Transferee/Donee: $ 4. IS THIS A GIFT IN WHOLE OR IN PART? Yes If yes, enter the fair market value here $ below and proceed to # 7. Name of Transferor/Donor: Please 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) may be required to file Form 709 (Federal Gift Tax Return) with the Internal Revenue Service. Please 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) __________________________, declare under the penalty of perjury, that I have read the aforementioned paragraph and acknowledge that a Federal Gift Tax may be triggered. _____________________________________ Signature City Hall Office: 1 Dr. Carlton B. Goodlett Place Room 190, San Francisco, CA 94102-4698 Tel: (415) 554-5596 Fax: (415) 554-7151 www.sfassessor.org e-mail: assessor@sfgov.org Rev. 1/4/12 American LegalNet, Inc. www.FormsWorkFlow.com 5. DO YOU CONTEND THAT NO TRANSFER TAX IS DUE FOR A REASON NOT EXPLAINED ABOVE? Yes No (If no, proceed to #6) If yes, explain fully: (1) The nature of this transaction; and (2) The reason why you contend no transfer tax is due. (Use additional papers if necessary and attach copies of records or documents to support your claim, i.e., Tax Returns, Entity Formation Documents.) 6. TAXABLE TRANSACTIONS Complete the following and calculate the tax below: a. Consideration Paid (including the value of any lien or encumbrance remaining thereon at the time of transfer): b. Fair Market Value: c. Tax Due: $ $ $ Effective December 17, 2010, as mandated through local ordinance, the transfer tax rates are as follows: If entire value or consideration is: More than $100 but Less Than or Equal to $250,000 More than $250,000 but Less Than $1,000,000 $1,000,000 or More but Less Than $5,000,000 $5,000,000 or More but Less Than $10,000,000 $10,000,000 or More Tax rate for entire value or consideration is: $2.50 for each $500 or portion thereof $3.40 for each $500 or portion thereof $3.75 for each $500 or portion thereof $10.00 for each $500 or portion thereof $12.50 for each $500 or portion thereof 7. CONTACT INFORMATION a. NAME OF CONTACT PERSON: b. TELEPHONE NUMBER: ( c. MAILING ADDRESS: ) I DECLARE OR AFFIRM UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Transferee Print New Property Owner Name (Transferee) Place of Execution (City, County, State where executed) Date of Execution NOTICE: ANY MATERIAL MISREPRESENTATION OF FACT IN THIS AFFIDAVIT IS A MISDEMEANOR UNDER SECTION 1116 OF THE REAL PROPERTY TRANSER TAX ORDINANCE. ANY PERSON WHO MAKES SUCH A MISREPRESENTATION IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE. American LegalNet, Inc. www.FormsWorkFlow.com
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