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PRELIMINARY CHANGE OF OWI HIP REPORT <br />Please answer, to the best of your kncwledge. — .,,,,,cable questions, sign and date. If a questi�_ _ - - not apply. Indicate with -N/A." <br />PART III: PURCHASE PRICE AND TERMS OF SALE <br />A. CASH DOWN PAYMENT OR Value of Trade or Exchange (excluding closing costs) Amount S N/A <br />B. FIRST DEED OF TRUST % interest for years. Pymts./Mo. = S (Prin. & Int. only) AmountS N/A <br />❑ FHA ( Discount Points) ❑ Fixed Rate ❑ New Loan <br />❑ Conventional ❑ Variable Rate ❑ Assumed Existing Loan Balance <br />❑ VA (—Discount Points) ❑ All inclusive D.T. (S Wrapped) ❑ Bank or Savings & Loan <br />❑ Cal -Vet ❑ Loan carried by Seller ❑ Finance Company <br />Balloon Payment []Yes ❑ No Due Date Amount <br />C. SECOND DEED OF TRUST % interest for years. Pymts./Mo. = S (Prin. & Int. only) AmountS N/A <br />❑ Bank or Savings & Loan ❑ Fixed Rate ❑ New Loan <br />❑ Loan Carried by Seller - ❑ Variable Rate ❑ Assumed Existing Loan Balance <br />Balloon Payment ❑ Yes ❑ No Due Date Amount S <br />D. OTHER FINANCING: Is other financing involved not covered in (b) or (c) above? ❑ Yes ❑ No Amount S N/A <br />Type ® % interest for. <br />❑ Bank or Savings & Loan ❑ Fixed Rate <br />❑ Loan Carried by Seller ❑ Variable Rate <br />Balloon Payment ❑ Yes ❑ No <br />years. Pymts./Mo. = S (Prin. & Int only) <br />❑ New Loan <br />❑ Assumed Existing Loan Balance <br />Due Date Amount S <br />E. IMPROVEMENT BOND []Yes ❑ No Outstanding Balance: Amount S N/A <br />F. TOTAL PURCHASE PRICE (or acquisition price, if traded or exchanged, include real estate commission if paid.) <br />ACQUIRED Total Items A through E $ N/A <br />G. PROPERTY ❑ Through a broker ❑ Direct from seller ® Other (explain) SunM p� vacation <br />If purchased through a broker, provide broker's name and phone number. <br />Please explain any special terms, seller concessions, or financing and any other information that would help the Assessor understand the <br />purchase price and terms of sale. <br />The property was not purchased It was acquired through a s=ary vacation. <br />PART IV: PROPERTY INFORMATION <br />A. IS PERSONAL PROPERTY INCLUDED IN PURCHASE PRICE (i.e., furniture, farm equipment, etc.) <br />(other than a mobilehome subject to local property tax)? ❑ Yes ® No <br />If yes, enter the value of the personal property included in the purchase price $ (Attach itemized list of personal property) <br />B. IS THIS PROPERTY INTENDED AS YOUR PRINCIPAL RESIDENCE? ❑ Yes ® No <br />If yes, enter date of occupancy / , 19 or intended occupancy , 19 . <br />MONTH DAY MONTH DAY <br />C. TYPE OF PROPERTY TRANSFERRED: <br />❑ Single-family residence ❑ Agricultural ❑ Timeshare <br />❑ Multiple -family residence (no. of units: ) ❑ Co-op/Own-your-own ❑ Mobilehome <br />❑ Commercial/Industrial ❑ Condominium ❑ Unimproved lot <br />E Other (Description: Excess street right-of-way <br />D. DOES THE PROPERTY_ PRODUCE INCOME? - ElYes ® No If yes, is the income from: <br />' ❑ Lease/Rerit ❑Contract �❑ Mineral Rights — E]Otiver—Explain: ' ---- -" <br />E. WHAT WAS THE CONDITION OF THE PROPERTY AT THE TIME OF SXIZ7. ACQUISITION? <br />® Good ❑ Average ❑ Fair " * ❑ Poor <br />Please explain the physical condition of the property and provide any other information (such as restrictions, etc.) that would assist the <br />Assessor in determining the value of the property. <br />Ice at the foregoing is true, correct and complete to the best of my knowledge and belief. <br />t <br />Signed S Date <br />NEW oFPIGER_ <br />Please Print Name of New Owner/Corporate Officer <br />Phone Number where you are available from 8:00 a.m.-5:00 p.m. (S--/q 10 3'? '914:50 <br />(NOTE: The Assessor may contact you for further information) <br />If a document evidencing a change of ownership is presented to the recorder for recordation without the concurrent filing of a preliminary <br />change of ownership report, the recorder may charge an additional recording fee of twenty dollars ($20). <br />