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pocuSign Envelope ID: 683C3E0C-95FA-43E0-B07A-8391 E292F846 <br />U,40t4g <br />EF-502-A-R14-O518-01002292-1 <br />BOE-502-A(P1)REV.14(05-18)PRELIMINARY CHANGE OF OWNERSHIP REPORTTo be completed by the transferee (buyer) prior to a transfer of <br />subject property, in accordance with section 480.3 of the Revenue and <br />Taxation Code. A Preliminary Change of Ownership Report must <br />be filed with each conveyance in the County Recorder's office <br />for the county where the property is located. <br />NAME AND MAILING ADDRESS OF BVYERITRANSFEREE ASSESSOR'S PARCEL NUMBER <br />(Make necessary corrections to the printed name and marling address <br />7 412-0001-004-01 <br />SELL�RJYP+SWSF£ROR <br />Parshotam, Incorporated, a California corporation <br />BUYER'S DAYTIME TELEPHONE NUMBER <br />( 510 ) 577-6003 — <br />BUYER'S EMAILAODRESS <br />1 tliao@sanleandro.org <br />r- <br />City of San Leandro <br />835 E 14th <br />San Leandro, CA 94577 <br />COUNTY OF ALAMEDA <br />PHONG LA, ASSESSOR <br />1221 Oak St., Rm 145 <br />Oakland, Ca. 94612-4288 <br />(510) 272-3787 Fax (510) 272-3803 <br />www.acgov.ofg/assessor <br />STREETADDRESS OR PHYSICAL LOCATIONOF REAL PROPERTY <br />555 Lewelling Boulevard, San Leandro, CA 94579 <br />❑ YES © NO Tws property Is intended as my pflociRal resldence. If YES, pt"5a Indicate Ilse date of occupancy <br />or intended occupancy, <br />❑ YES NO Are you a disabled veteran or a unmarried surviving spouse of a disabled veteran who was <br />compensated at 100% by the Department of Veterans Affairs? <br />I r.►o nnr rift <br />MAIL PROPERTY TAX INFORMATION TO (NAME) <br />city of san Leandro, A Municipal Corporation <br />MAIL PROPERTY TAX INFORMATFON TO (ADDRESS) GTY BTRTp iPC01511 <br />Community Development Dept, 835 E. 14th St. ISan Leandro <br />PART 1. TRANSFER INFORMATION Please complete all statements <br />YES NO This section contains possible exclusions from reassessment for certain types of transfers. <br />11 ✓❑ A. Tbis transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement etc.). <br />❑ B. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition or removal of <br />a partner, death of a partner, termination settlement, etc.). <br />❑ ❑✓❑✓ * C. <br />❑ O * D. <br />❑ Z*E. <br />❑ 0`F <br />❑ g G <br />This is a transfer: ❑ between parent(s) and child(ren) ❑ from grandparent(s) to grandchild(ren). <br />This transfer is the result of a cotenant's death. Date of death <br />This transaction is to replace a principal residence owned by a person 55 years of age or older. <br />Within the same County? Dyes ❑ No <br />This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code <br />section 69.5. Within the same county? ❑ YES ❑ NO <br />This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage). <br />If YES, please explain: -- - <br />❑ <br />❑✓ H. <br />The recorded document creates, terminates, or reconveys a lender's interest in the property. <br />❑ <br />0 I. <br />This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest <br />(e.g., cosigner). If YES, please explain: <br />❑ <br />R J. <br />The recorded document substitutes a trustee of a trust, mortgage, or other similar document, <br />K. <br />This is a transfer of property' <br />❑ <br />V <br />1. to/from a revocable trust that may be revoked by the transferor and is for the benefit of <br />❑ the transferor, and/or ❑ the transferor's spouse ❑ registered domestic partner. <br />W12. <br />u <br />to/from an irrevocable trust for the benefit of the <br />❑ creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantor's/trustor's registered domestic partner. <br />❑ <br />L. <br />This property is subject to a lease with a remaining lease term of 35 years or more including written options. <br />M. <br />This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel <br />being transferred remain exactly the same after the transfer. <br />N. <br />This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions, or restrictions <br />irnposed by specified nonprofit corporations. <br />❑ <br />* O. <br />This transfer is to the first purchaser of a new building containing an active solar energy system, <br />❑ P. <br />Other. This transfer is to purchase the properLV <br />* Please <br />refer to the instructions for Part 1. <br />Pf a_sc+ provide an d%4> c linfqrmatlan that wJll itielp the Assessor un erstamd the nature of the transfer. <br />IIIII' II IIII <br />III{I <br />THIS DOCUMENT IS NOTSUBJECT TO PUBLIC INSPECTION <br />III I IIIIjI I II II IIIIIiII I II III i II III II IIII I II <br />