93517 58 Ah

User Manual: 93517

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SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE
SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE
MAILING ADDRESS
( )
BOE-58-AH (P1) REV. 1 (0-1)
CLAIM FOR REASSESSMENT EXCLUSION FOR
TRANSFER BETWEEN PARENT AND CHILD
A. PROPERTY
ASSESSOR’S PARCEL NUMBER
PROPERTY ADDRESS CITY
RECORDER’S DOCUMENT NUMBER DATE OF PURCHASE OR TRANSFER
PROBATE NUMBER (if applicable) DATE OF DEATH (if applicable) DATE OF DECREE OF DISTRIBUTION (if applicable)
The disclosure of social security numbers is mandatory as required by Revenue and Taxation Code section 63.1. [See Title 42 United
States Code, section 405(c)(2)(C)(i) which authorizes the use of social security numbers for identication purposes in the administration of any
tax.] A foreign national who cannot obtain a social security number may provide a tax identication number issued by the Internal Revenue
Service. The numbers are used by the Assessor and the state to monitor the exclusion limit.
1. Print full name(s) of transferor(s)
2. Social security number(s)
3. Family relationship(s) to transferee(s)
If adopted, age at time of adoption
4. Was this property the transferor’s principal residence? Yes No
If yes, please check which of the following exemptions was granted or was eligible to be granted on this property:
Homeowners’ Exemption Disabled Veterans’ Exemption
5. HavetherebeenotherWUDQVIHUsthatqualiedforthisexclusion? Yes No
6. Was only a partial interest in the property transferred?
If yes,pleaseattachalistofallprevioustransfersthatqualiedforthisexclusion.(Thislistshouldincludeforeachproperty:theCounty,
Assessor’s parcel number, address, date of transfer, names of all the transferees/buyers, and family relationship. Transferor’s principal
residencemustbeidentied.)
Yes No If yes, percentage transferred %
7. Was this property owned in joint tenancy? Yes No
B. TRANSFEROR(S)/SELLER(S) (additional transferors please complete “B” on the reverse)
8. If the transfer was through the medium of a trust, you must attach a copy of the trust.
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any
accompanying statements or documents, is true and correct to the best of my knowledge and that I am the parent or child (or transferor’s legal
representative) of the transferees listed in Section C. I knowingly am granting this exclusion and will not le a claim to transfer the base year value
of my principal residence under Revenue and Taxation Code section 69.5.
DAYTIME PHONE NUMBER
CITY, STATE, ZIP EMAIL ADDRESS
DATE
DATE
t
t
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address.)
(Please complete applicable information on reverse side.)
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
Mono County Assessor
P.O. Box 456
Bridgeport, CA 93517
760-932-5510
Barry Beck
BOE-58-AH (P2) REV. 15 (06-11)
C. TRANSFEREE(S) / BUYER(S) (additional transferees please complete “C” below)
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any
accompanying statements or documents, is true and correct to the best of my knowledge and that I am the parent or child (or transferee’s legal
representative) of the transferors listed in Section B; and that all of the transferees are eligible transferees within the meaning of section 63.1 of
the Revenue and Taxation Code.
NAME SOCIAL SECURITY NUMBER SIGNATURE RELATIONSHIP
NAME RELATIONSHIP
CERTIFICATION
1. Print full name(s) of transferee(s)
2. Family relationship(s) to transferor(s)
If adopted, age at time of adoption
If stepparent/stepchild relationship is involved, was parent still married to or in a registered domestic partnership (registered means
registered with the California Secretary of State) with stepparent on the date of purchase or transfer? Yes No
If no, was the marriage or registered domestic partnership terminated by: Death Divorce/Termination of partnership
If terminated by death, had the surviving stepparent remarried or entered into a registered domestic partnership as of the date of purchase
or transfer? Yes No
If in-law relationship is involved, was the son-in-law or daughter-in-law still married to or in a registered domestic partnership with the
daughter or son on the date of purchase or transfer? Yes No
If no, was the marriage or registered domestic partnership terminated by: Death Divorce/Termination of partnership
If terminated by death, had the surviving son-in-law or daughter-in-law remarried or entered into a registered domestic partnership as of
the date of purchase or transfer? Yes No
3. ALLOCATION OF EXCLUSION (If the full cash value of the real property transferred exceeds the one million dollar value exclusion, the
transferee must specify on an attachment to this claim the amount and allocation of the exclusion that is being sought.)
SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVE
SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVE
MAILING ADDRESS
( )
CITY, STATE, ZIP EMAIL ADDRESS
DATE
DATE
DAYTIME PHONE NUMBER
t
t
C. TRANSFEREE(S) / BUYER(S) (additional transferees please complete “C” below)
3. ALLOCATION OF EXCLUSION (If the full cash value of the real property transferred exceeds the one million dollar value exclusion, the
transferee must specify on an attachment to this claim the amount and allocation of the exclusion that is being sought.)
CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any
accompanying statements or documents, is true and correct to the best of my knowledge and that I am the parent or child (or transferee’s legal
representative) of the transferors listed in Section B; and that all of the transferees are eligible transferees within the meaning of section 63.1 of
the Revenue and Taxation Code.
Note: The Assessor may contact you for additional information.
B. ADDITIONAL TRANSFEROR(S)/ SELLER(S) (continued)
C. ADDITIONAL TRANSFEREE(S) / BUYER(S) (continued)
Mono County Assessor
P.O. Box 456
Bridgeport, CA 93517
760-932-5510
CLAIM FOR REASSESSMENT EXCLUSION FOR TRANSFER BETWEEN PARENT AND CHILD
Revenue and Taxation Code, Section 63.1
IMPORTANT: Inordertoqualifyforthisexclusion,aclaimformmustbecompletedandsignedbythetransferorsandatransfereeandledwiththe
Assessor.Aclaimformistimelyledifitisledwithinthreeyearsafterthedateofpurchaseortransfer,orpriortothetransferoftherealproperty
toathirdparty,whicheverisearlier.Ifaclaimformhasnotbeenledbythedatespeciedintheprecedingsentence,itwillbetimelyifledwithin
sixmonthsafterthedateofmailingofanoticeofsupplementalorescapeassessmentforthisproperty.Ifaclaimisnottimelyled,theexclusion
willbegrantedbeginningwiththecalendaryearinwhichyouleyourclaim.CompleteallofSectionsA,B,andCandanswereachquestionor
your claim may be denied. Proof of eligibility, including a copy of the transfer document, trust, or will, may be required. Please note:
1. This exclusion only applies to transfers that occur on or after November 6, 1986;
2. In order to qualify, the real property must be transferred from parents to their children or children to their parents;
3. If you do not complete and return this form, it may result in this property being reassessed.
4. California law provides, with certain limitations, that a “change in ownership” does not include the purchase or transfer of:
•Theprincipalresidencebetweenparentsandchildren,and/or
•Therst$1,000,000ofotherrealpropertybetweenparentsandchildren.
NOTE: Effective January 1, 2009, Revenue and Taxation Code Section 63.1(j) allows a county board of supervisors to authorize a one-time
processingfeeofnotmorethan$175torecovercostsincurredbythecountyassessorduetothefailureofaneligibletransfereetoleaclaimfor
the parent-child change in ownership exclusion after two written requests have been sent to an eligible transferee by the county assessor.
 
 
BOE-58-AH (P3) REV. 15 (06-11)
Mono County Assessor
P.O. Box 456
Bridgeport, CA 93517
760-932-5510

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