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NGE IN OWNERSHIP STATEME <br />ee Important Notice on Reverse; <br />PART B: Transfers <br />Please check the appropriate box in each of Columns 1, 2, and 3 to indicate (1) the legal status of the owner of the property, <br />(2) how the property was acquired, and (3) how the owner holds title to it. <br />THE PERSON(S) OR LEGAL ENTITY NAME OF TRUSTEE FORM OF OWNERSHIP <br />ACQUIRING THE PROPERTY IS (ARE): HOW ACQUIRED? BY: OR CO -OWNERSHIP <br />COLUMN 1 COLUMN 2 COLUMN 3 <br />Indlvldual(s) <br />❑ <br />Purchase ❑ <br />Corporation <br />❑ <br />Gift ❑ <br />Partners <br />❑ <br />Inheritance ❑ <br />Trustee for <br />❑ <br />Trade/Exchange ❑ <br />❑ <br />Foreclosure Sale ❑ <br />NAME OF TRUSTEE <br />Court Order ❑ <br />Other ` Mun Cinal Cor�w <br />Other see footnote <br />❑ <br />ESC IB <br />EXPLAIN <br />If less than too percent of the property transferred, indicate percentage transferred <br />PART C: Property Information <br />1. Type of Property <br />❑ Single Family Residence <br />❑ Condominium or Co-op <br />❑ Multi -Family <br />❑ Commercial or Industrial <br />Sole Owner <br />Joint Tenancy <br />Community Property <br />Tenant in Common <br />or Partnership <br />❑ Agricultural <br />❑ Mobile Home Lot <br />XX Bare Land <br />❑ Other <br />X <br />Does this property produce Income? ❑ YES 10 NO DESCRIBE <br />If "Yes," please attach a current income and expense statement for this property. <br />2. If the property is subject to a lease, state original term (include options) and beginning date of lease <br />3. Purchase Information. <br />Purchase price agreed to by buyer and seller: $ see footnote <br />Date o4 Purchase Aug 22 19 79 Total Cash Down Payment $ — <br />Financing: <br />❑ Conventional (Savings & Loan, ❑ Cal Vet ❑ VA ❑ Assumed Existing Loan <br />Bank, Insurance Company) ❑ FHA ❑ Seller T Other tee footnote <br />WRAPAROUND, ALL INCLUSIVE DEEDS. ETC. <br />LOAN AMOUNT INTEREST RATE REMAINING TERM NEW LOAN ASSUMED LOAN <br />1st Trust Deed $ % Yrs. ❑ ❑ <br />Other $ % Yrs. ❑ ❑ <br />If an improvement bond(s) was assumed under the purchase agreement, enter the amount $ <br />If a trade/exchange was involved, describe type of property traded and its value. <br />DESCRIPTION <br />If personal property was included, enter its description and value <br />VALUE <br />DESCRIPTION VALUE <br />NOTE: Personal property includes, but is not limited to, unattached items such as mobile homes, free-standing appliances, and <br />furniture. Attach an itemized listing, if available. <br />Was this property purchased by "Contract of Sale." ❑ YES ❑ NO If yes, enter the date of the contract <br />4. Portion of taxes paid by tenant? Yes ❑ No ❑ <br />Were there any tenant improvements? Yes ❑ No ❑ If yes, amount $ <br />5. Is the Lender to pay taxes? Yes ❑ No ❑ <br />6. Other Transfers <br />If you did not purchase this property, please explain the circumstances of the transfer. see footnote* <br />Is this property your principal residence? ❑ Yes IR No <br />The Assessor's Office may contact you for additional information regarding this transaction <br />1 DECLARE UNDER PENALTY OF PERJURY THAT, TO THE BEST OF MY KNOWLEDGE <br />AND BELIEF, THE FORGOING IS TRUE AND CORRECT. <br />Signed San Leandro April 7 80 <br />California, on 19 _ <br />MONTH DAY <br />1 v.` Publ is Uorks Director <br />SIGNATURE OF OWNER OR CORPO ATE OFFICER TITLE <br />ASSESSOR'S USE ONLY <br />Property deeded directly to City. Purchase price paid by third party (developer of <br />adjacent property, as a condition of development). Purchase price and method of <br />financing unknown. <br />