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e0E-502-A(P2)REV. 15 (02.21) <br />PART 2. OTHER TRANSFER INFORMATION Check and complete as applicable, <br />A. Dale of transfer, If other than recording date: <br />B. Type of Transfer <br />Purchase ❑ Foreclosure ❑ Gift ❑ Trade or exchan a ❑OMerger, stock, or partnership acquisition (Form BOE-100-B) <br />❑ Contract of sale. Date of contract I . a' / 2- I / .. a / ❑ Inheritance. Date of death: <br />❑ Saleileaseback ❑ Creation of a lease ❑ Assignment of a lease Cl Termination of a lease. Date lease began: <br />Original term In years (Including written options): Remaining term in years (including written options): <br />❑ Other. Please explain <br />C. Only a partial interest in the property was transferred, ❑ YES IP'NO If YES, Indicate the percentage transferred: <br />% <br />PART 3, PURCHASE PRICE AND TERMS OF SALE Check and complete as applicable, <br />A. Total purchase price. <br />$ fj pQ <br />B. Gash down payment or value of trade or exchange excluding closing costs Amount <br />$ <br />C. First deed of trust @ _,% Interest for years. Monthly payment $ Amount <br />$ <br />❑ FI-IA ( aamum Pain) ❑ Cal -Vet ❑ VA (DIo I P0Inta) ❑ Fixed rate ❑ Varlable rate <br />❑ SanklSovings & Loan/Credit Union ❑ Loan carried by seller <br />❑ Balloon payment $ Due date: <br />D. Second deed of trust @ T % Interest for years. Monthly payment $ Amount <br />$� <br />❑ Fixed rate ❑ Variable mlo ❑ BankiSavings & LoardGredit Union ❑ Loan carried by solior <br />❑ Balloon payment $ Due date: _ <br />_ <br />E. Was an improvement Bond or other public financing assumed by the buyer? ❑ YES ❑ NO outstanding Balance <br />$ <br />F. Amount, if any, of real estate commission fees paid by the buyer which are not Included In the purchase price <br />$ <br />G. The property was purchased: ❑ Through real estate broker. Broker name: Phone number j_ ) <br />PK Direct from seller ❑ From a (amity member -Relationship <br />❑ Other. Please explain: <br />FI. Please explain any spacial terms, seller concessions, broker/agent fees waived, financing, and any other Information (e.g., buyer assumed the <br />existing loan balance) that would assist the Assessor in the valuation of your properly. <br />PART 4. PROPERTY INFORMATION Chock and complete as applicable. <br />A. Type of property transferred <br />Single-family residence ❑ Co-oplOwn•your-awn ❑ Manufactured home <br />❑ Multlple-family residence, Number of units: ❑ Condominium )4 Unimproved lot <br />❑ Other. Description: (i.e., timber, mineral, water rights, etc.) ❑ Timeshare ❑ Commercial/Industrial <br />B. ❑ YES IgNO Personaftbusinoss property, or incentives, provided by seller to buyer are Included In the purchase price. Examples of personal <br />property are furniture, farm equipment, machinery, etc. Examples of Incentives are club memberships, etc. Attach list if available. <br />if YES, enter the value of the personal/business property: $ Incentives S <br />C. ❑ YES 1 NO A manufactured home Is Includedin the purchase. price. <br />If YES, enter the value attributed to the manufactured home: $ <br />❑ YES ❑ NO The manufactured home is subject to local property tax. If NO, enter decal number <br />D. ❑ YES F NO The property produces rental or other Income. <br />If YES, the Income Is from: 13 Leaseirent ❑ Contract ❑ Mineral rights ❑ Other: <br />E. The condition of the property at the time of sale was: ❑ Good ❑ Average $'Fair CJ Poor <br />Please describe: <br />CERTIFICATION <br />l certify (or declare) that the foregoing end all information hereon, Including any accompanying statements or documents, is true and correct to the best <br />of my knowledge and belief <br />NAME OF 6UVER/rap,NS EREEPERSONAL REPRESENTATIVE(CORPORATE UPPICER(PLEASE MINT) ITLE EMAIL APOR <br />Ja? AAb l/ d Rr 4dU1 f'Yl,�)V#f'eAr 110a +AN <br />The Assessor's office may contact you for additional information regarding this transaction. <br />$FRM0017 (DSI Rev. 02118121) <br />C'oJ <br />