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30E-502-A(P1) REV, 14 (05-18) PRELIMINARY CHANGE OF OWNERSHIP REPORT To be completed by the transferee (buyer) prior to a transfer of subject property, in accordance with Section 480.3 of the Revenue and Taxation Code, A Preliminary Change of Ownership Report must be filed with each conveyance In the County Recorder's office for the county where the property Is located. NAME AND MAILING ADDRESS OF BUYERfrRANSFEREE (ock, necessary c,nealana to Be printed name and mailing address) City of Santa Ana, a charter city and municipal Corporation duly ASSESSOR'S PARCEL NUMBER organized under the Constitution and laws of the State of California 016-103-22 20 Civic Center Plaza, M-3.6 SELLERITRANSFEROR Santa Ana, CA 92701 VeroniquG Pham BUYER'S DAYTIME TELEPHONE NUMBER BUYER'S EMAIL ADDRF_SS Jgabriel@serifs-a na,Drq STREET AODRE55 OR PHYSICAL LOCATION OP REAL PROPERTY 2241-2245 S. Kilson Drive, Santa Ana, CA 92707 ❑ YES 0 NO This property is Intended as my principal residence. If YES, please indicate the dale of occupancy MO DAY YEAR or intended occupancy. ❑ YES ONO Are you a disabled veteran or an unmarried surviving spouse of a disabled veteran who was compensated at 100% by the Department of Veterans Affairs? MAIL PROPER 'I'Y'FAX INFORMATION TO (NAME) INFORMATION TO (ADDRESS) ZIP PART I: TRANSFER INFORMATION Please complete all statements. This section contains possible exclusions from reassessment for certain types of transfers. YES NO ❑ ❑ A. This transfer Is solely between spouses (addition orremoval ofa spouse, death ofa spouse, d umme settlement, etc.). ❑ ld S. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition or removal of partner, death of partner, termination settlement, etc.). ❑ 0- C. This is a transfer: ❑ between parent(s) and ehlltl(ren) Lf from grandparent(s) to grandchild(ren). ❑ 0- D. This transfer is the result of a cotenant's death. Date of death ❑ ® " E. This transaction is to replace a principal residence by a person 65 years of age or older. Within the same county? ❑ YES ❑ NO ❑ O`F. ❑ IZ O ■ L This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code section 60.6. Within the same county? O YES ❑ NO This transaction is only a correction of the names) of the persons) holding title to the property (e.g., a name changeuporr marriage). If YES, please explain: The recorded document creates, terminates, or reconveys a lender's interest in the property. This transaction Is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest (e.g., cosigner). If YES, please explain: The recorded document substitutes a trustee of a trust, mortgage, or other similar document This is a transfer of property: 1, to/from a revocable trust that may be revoked by the transferor and is for the benefit of ❑ the hansferoi. and/or ❑ the transferor's spouse ❑ registered domestic partner. 2. to/from an Irrevocable trust for the benefit of the ❑ creator/grantor/truster and/or ❑ grantor's/trustor's spouse ❑ grantor's/trustor's registered domestic partner. ❑ I., This property is subject to a lease with a remaining lease term of 36 years or more including written options, ❑ Iv-i M. This Is a transfer between parties in which proportional interests of the transferors) and transferoe(s) in each and every parcel being transferred remain exactly the same after the transfer. ❑ Ed N This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions, or restrictions Imposed by specified nonprofit corporations. ❑ ®' O, This transfer Is to the first purchaser of a new building containing an active solar energy system. ❑ ❑ P. Other. This transfer Is to Please refer to the instructions for Part t. Please provide any other information that will help the Assessor understand the nature of the transfer. THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION SFRM0017 (DSI Rev. 08131/20)