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PRELIMINARY CHANGE OF OWNERSHIP REPORT <br />(To be completed by transferee (buyer) prior to transfer of subject property in accordance with Section 480.3 of <br />the Revenue and Taxation Code.) A Preliminary Change of Ownership Report must be filed with each <br />conveyance in the County Recorder's office for the county where the property is located; this particular form may <br />be used in all 58 counties of California. <br />THIS REPORT IS NOT A PUBLIC DOCUMENT <br />SELLER/TRANSFEROR: QUAN V. LE AND LAN N. TU LE AND TUNG Q. MA AND HUONG <br />T. LUU AND GARY VU AND LINH Q. MA <br />BUYER/TRANSFEREE: CITY OF SAN LEANDRO <br />ASSESSOR'S PARCEL NUMBER(S): portion of 77A-650-3-11 <br />PROPERTY ADDRESS OR LOCATION: PORTION OF 2650 ALVARADO STREET, SAN <br />LEANDRO, CA 94577 <br />MAIL TAX INFORMATION TO: CITY OF SAN LEANDRO, 835 East 14th Street, San Leandro, <br />CA 94577 <br />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 <br />of these taxes is due November 1, and one-half is due February 1. The first installment becomes delinquent on December 10, and the second installment becomes <br />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 <br />DECEMBER 31, YOU MAY BE RESPONSIBLE FOR THE SECOND INSTALLMENT OF TAXES DUE FEBRUARY 1. <br />The property which you acquired may be subject to a supplemental assessment in an amount to be determined by the ALAMEDA County Assessor. For further <br />information on your supplemental roll obligation, please call the ALAMEDA County Assessor. <br />PART I: TRANSFER INFORMATION Please answer all questions. <br />YES NO <br />❑ � A. Is this transfer solely between husband and wife (Addition of a spouse, death of a spouse, divorce settlement, etc.)? <br />❑ 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 <br />upon marriage)? <br />❑ [� C. Is this document recorded to create, terminate, or reconvey a lender's interest in the property? <br />❑ Q/ D. Is this transaction recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security <br />interest cosigner)? <br />Eljj'/ E. Is this document recorded to substitute a trustee under a deed of trust, mortgage, or other similar document? <br />❑ F. Did this transfer result in the creation of a joint tenancy in which the seller (transferor) remains as one of the joint tenants? <br />❑ [� G. Does this transfer return property to the person who created the joint tenancy (original transferor)? <br />H. Is this transfer of property: <br />❑ 1. to a trust for the benefit of the grantor, or grantor's spouse? <br />❑ 2. to a trust revocable by the transferor? <br />❑ 3. to a trust from which the property reverts to the grantor within 12 years? <br />❑ I. If this property is subject to a lease, is the remaining lease term 35 years or more including written options? <br />❑ J.* Is this a transfer between parent(s) and child(ren)? ❑ or from grandparent(s) to grandchild(ren)? <br />❑ K.* Is this transaction to replace a principal resident by a person 55 years of age or older? <br />Within the same county? ❑ Yes ❑ No <br />❑ Is this transaction to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation <br />Code Section 69.5? Within the same county? ❑ Yes ❑ No <br />❑ M. Did this transfer result from the death of a domestic partner currently registered with the California Secretary of State? <br />* 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 <br />property. Failure to file a claim results in the reassessment of the property. <br />Please provide any other information that would help the Assessor to understand the nature of the transfer. <br />PROPERTY BEING ACQUIRED FOR STREET WIDENING PURPOSES ONLY. <br />IF YOU HAVE ANSWERED "YES" TO ANY OF THE ABOVE QUESTIONS EXCEPT J, K OR L, PLEASE SIGN AND DATE, OTHERWISE <br />COMPLETE BALANCE OF THE FORM. <br />PART II: OTHER TRANSFER INFORMATION <br />A. Datef transfer if other than recording date: <br />B. f transfer. Please check appropriate box. <br />chase ❑ Foreclosure ❑ Gift ❑ Trade or Exchange ❑ Merger, Stock, or Partnership Acquisition <br />❑ Contract of Sale - Date of Contract: <br />❑ Inheritance - Date of Death: ❑ ❑ Other: Please explain: <br />❑ Creation of Lease [-I Assignment of a Lease ❑ Termination of a Lease[:] Sale/Leaseback <br />❑ Date lease began: <br />❑ Original term in years (including written options): <br />❑ Remaining term in years (including written options): <br />C. Was only a partial interest in the property transferred? Yes ❑ No <br />If yes, indicate the percentage transferred: .017 % <br />Page 1 of 2 - 5/24/05 <br />n�ornn a...- invim� <br />