Change Of Ownership Statement (Marin County) {BOE-502-AH}

BOE-502-A(P1) REV. 1 (0-17) þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ E. This transaction is to replace a principal residence owned by a person 55 years of age or older. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ STATE þ YESYESYES þ þ þ þ þ þ (addition or removal of a spouse, death of a spouse, divorce settlement, etc.). þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ (addition or removal ofa partner, death of a partner, termination settlement, etc.). þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ G. þ 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). þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ (e.g., cosigner) þ þ þ þ þ þ þ between parent(s) and child(ren)from grandparent(s) to grandchild(ren). ( ) þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ **** YES þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ MODAYYEARM.This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel þ þ þ þ CHANGE OF OWNERSHIP þ þ þ þ þ þ þ þ þ þ þ þ * YES þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ PART 1. TRANSFER INFORMATION Please complete all statements.Please provide any other information that will help the Assessor understand the nature of the transfer.THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION American LegalNet, Inc. www.FormsWorkFlow.com BOE-502-A (P2) REV. 1 (0-17) Remaining term in years (including written options) PART 2. OTHER TRANSFER INFORMATION Check and complete as applicable. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Variable rateVariable rate þ þ Original term in years (including written options)Assignment of a lease þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Gift þ þ þ þ þ þ þ þ YES % A. Type of property transferred Single-family residence þ þ þ þ þ TimeshareMineral rights þ þ þ þ þ þ þ þ B.D.E. YESYESYESYESYESGoodAverageFairPoor þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ DATE þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Direct from sellerFrom a family member-Relationship ( ) þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ ( )Incentives þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ ) þ þ ) þ þ PART 3. PURCHASE PRICE AND TERMS OF SALECheck and complete as applicable.PART 4. PROPERTY INFORMATIONCheck and complete as applicable.CERTIFICATIONI certify (or declare) 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. American LegalNet, Inc. www.FormsWorkFlow.com BOE-502-A (P3) REV. 1 (0-17) location of the real property. NOTE: Your telephone number and/or email address is very important. If there is a question or a problem, the Assessor needs to be able to contact you. requirements met in order to obtain the exemption. Please contact the Assessor for a claim form. PART 1: TRANSFER INFORMATIONIf you check YES to any of these statements, the Assessor may ask for supporting documentation. C, D, E, F:these exclusions. G: H:in the property. "" I: A "cosigner" M: the same. N: O:met in order to obtain the exclusion. Contact the Assessor for a claim form. PART 2: OTHER TRANSFER INFORMATION A: B:sheet if necessary. C.Change in OwnershipStatement, Death of Real Property Owner, American LegalNet, Inc. www.FormsWorkFlow.com PART 3: PURCHASE PRICE AND TERMS OF SALE A. 223Mortgage insurance224B.223Closing costs224C. A 223balloon payment224installment. D.E. An 223224 F. G.223Direct from seller224223From a family member224223OTHER224provide a detailed description (attach a separate sheet if necessary). H.PART 4: PROPERTY INFORMATIONA.B.provided.C.D.E.223fair224 or 223poor224brief description of repair needed. American LegalNet, Inc. www.FormsWorkFlow.com