COUNTY ASSESSOR

PRELIMINARY CHANGE OF OWNERSHIP REPORT		FOR RECORDERS USE ONLY
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 Recorder’s 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		FOR ASSESSORS USE ONLY
		APN
SELLER/TRANSFEROR:		RA Y N
BUYER/TRANSFEREE:		GRID MULTI
ASSESSOR’S PARCEL NUMBER(S):		REC DATE
PROPERTY ADDRESS OR LOCATION:		PP
MAIL TAX INFORMATION TO:	Name:	NV
	Address:
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 are due November 1, and one-half are due February 1. The first Installment becomes delinquent on April
10. One Tax bill is mailed before November 1 to the owner of record.
IF THIS TRANSFER OCCURS AFTER JANUARY 1 AND ON OR BEFORE DECEMBER 31, YOU MAY BE RESPONSIBLE FOR THE SECOND INSTALLMENT OF TAXES DUE FEBRUARY 1.
The property which you acquired may be subject to a supplemental assessment in an amount to be determined by the County Assessor. For Further information on your supplemental roll obligation, please call the County Assessor.

PART 1: TRANSFER INFORMATION Please answer all questions.

YES	NO
o	o	A.	Is this transfer solely between husband and wife (Addition of a spouse, death of a spouse, divorce settlement, etc.)?
o	o	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)?
o	o	C.	Is this document recorded to create, terminate or reconvey a lender’s interest in the property?
o	o	D.	Is this transaction recorded only as a requirement for financing purposes or to create, terminate or reconvey a security interest (e.g. cosigner)?
o	o	E.	Is this document recorded to substitute a trustee under a deed of trust, mortgage or other similar document?
o	o	F.	Did this transfer result in the creation of a joint tenancy in which the seller (transferor) remains as one of the joint tenants?
o	o	G.	Does this transfer return property to the person who created the joint tenancy (original transferor)?
o	o	H.	Is this transfer of property: 1. to a trust for the benefit of the grantor, or grantor’s spouse? 2. to a trust revocable by the transferor? 3. to a trust from which the property reverts to the grantor within 12 years?
o	o	I.	If this property is subject to a lease, is the remaining lease term 35 years or more including written options?
o	o	*J.	Is this transfer between parent(s) and child(ren)? o or from grandparent(s) to grandchild(ren)?
o	o	*K.	Is this transaction to replace a principal residence by a person 55 years of age or older? Within the same county? o Yes o No
o	o	*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? o Yes o No

*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. Failure to file a claim results in the reassessment of the property.

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

IF YOU HAVE ANSWERED “YES” TO ANY OF THE ABOVE QUESTIONS EXCEPT J, K, OR L, PLEASE SIGN AND DATE,

OTHERWISE COMPLETE BALANCE OF THE FORM

PART II: OTHER TRANSFER INFORMATION

A.	Date of transfer if other than recording date ________________________
B.	Type of transfer. Please check appropriate box.
	o Purchase	o Foreclosure	o Gift	o Trade or Exchange	o Merger, Stock or Partnership Acquisition
	o Contract of Sale - Date of Contract __________________
	o Inheritance - Date of Death _________________ o Other: Please explain: _______________________________
	o Creation of Lease o Assignment of a Lease o Termination of Lease o Sale/Leaseback
	o Date lease began ____________________
	o Original term in years (including written options) ______________________
	o Remaining term in years (including written options) ____________________
C.	Was only a partial interest in the property transferred? o Yes o No
If yes, indicate the percentage transferred ____________%

Please answer, to the best of your knowledge, all applicable questions, sign and date, if a question does not apply, indicate with “N/A”.

PCOR.doc

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 $______________________

o

FHA (______Discount Points)

o

Fixed Rate

o

New Loan

o

Conventional

o

Variable Rate

o

Assumed Existing Loan Balance

o

VA (______Discount Points)

o

All inclusive D.T. ($___________Wrapped)

o

Bank or Savings & Loan

o

Cal-Vet

o

Loan Carried by Seller

o

Finance Company

Balloon Payment

o Yes

o

No

Due Date ___________________ Amount $___________

C.

SECOND DEED OF TRUST @_____% interest for _____years. Pymts./Mo.=$_____ (Prin. & Int. only) Amount $_______________________

o

Bank or Savings & Loan

o

Fixed Rate

o

New Loan

o

Loan Carried by Seller

o

Variable Rate

o

Assumed Existing Loan Balance

Balloon Payment

o Yes

o

No

Due Date _________________ Amount $___________

D.

OTHER FINANCING: Is other financing involved not covered in (b) or (c) above?

o

Yes

o No Amount $____________________

Type ______________ @ _________% interest for _____years. Pymts./Mo.=$ ___________ (Prin. & Int. only)

o

Bank or Savings & Loan

o

Fixed Rate

o

New Loan

o

Loan Carried by Seller

o

Variable Rate

o

Assumed Existing Loan Balance

Balloon Payment

o Yes

o

No

Due Date _________________ Amount $____________

E.

WAS AN IMPROVEMENT BOND ASSUMED BY THE BUYER o Yes o 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 o Through a broker o Direct from seller o From a family member o Other (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:
	o	Single-family residence	o	Agricultural		o	Timeshare
	o	Multiple-family residence (no. of units: _____)	o	Co-op/Own-your own		o	Manufactured Home
	o	Commercial/Industrial	o	Condominium		o	Unimproved lot
	o	Other (Description: _____________________________________________________________________________________________)
B.	IS THIS PROPERTY INTENDED AS YOUR PRINCIPAL RESIDENCE?				o Yes	o No
	If yes, enter date of occupancy __________/___________, _________ or intended occupancy __________/__________. __________ 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)? o Yes o 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? o Yes o No If Yes, how much of the purchase price is allocated to the manufactured home? $________________ Is the manufactured home subject to local property tax? o Yes o No What is the Decal Number? _______________________________
E.	DOES THE PROPERTY PRODUCE INCOME? o Yes o No If yes, is the income from: o Lease/Rent o Contract o Mineral Rights o Other - Explain: __________________________________________________________
F.