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BOE-502-A (Pl) REV. 15 (02-21) <br />PRELIMINARY CHANGE OF OWNERSHIP REPORT <br />To be completed by the transferee (buyer) prior to a transfer of <br />subject property, in accordance with Section 480.3 of the Revenue <br />and 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 BUYERITRANSFEREE <br />(Make necessary corrections to the printed name and mailing address) <br />City of Santa Ana <br />20 Civic Center Plaza, M-36 P.O. Box 1988 <br />Santa Ana, CA 92707 <br />ASSESSOR'S PARCEL NUMBER <br />SELLER/TRANSFEROR <br />Gamboa Declaration of Trust <br />BUYER'S DAYTIME TELEPHONE NUMBER <br />(714)647-5664 <br />BUYER'S EMAIL ADDRESS <br />JGabriel@santa-ana.org <br />STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY <br />2247 South Evergreen Street, Santa Ana, CA 92707 <br />❑ YES El NO This property Is intended as my principal residence. If YES, please indicate the dale of occupancy MO I DAY I YEAR <br />or intended occupancy. <br />❑ YES ® NO Are you a disabled veteran or an unmarried surviving spouse of a disabled veteran who was <br />compensated at 100% by the Department of Veterans Affairs? <br />MAIL PROPERTY TAX INFORMATION TO (NAME) <br />City of Santa Ana <br />MAIL PROPERTY TAX INFORMATION TO (ADDRESS) CITY STATE ZIP CODE <br />PART I: TRANSFER INFORMATION Please complete all statements. <br />This section contains possible exclusions from reassessment for certain types of transfers. <br />YES NO <br />❑ I@ A. This transfer Is solely between spouses (addition orremoval of spouse, death ofa spouse, divorce settlement, etc.). <br />❑ EI B. This transfer Is solely between domestic partners currently registered with the California Secretary of State (addition or removal of a <br />partner, death of a partner, termination settlement, etc.). <br />❑ ®* C. This is a transfer: ❑ between parent(s) and chlld(ren) ❑ from grandparent(s) to grandchild(ren). <br />Was this the transferorigrantor's principal residence? ❑ YES ❑ NO <br />❑ EI * D. This transfer is the result of a cotenant's death. Date of death <br />❑ KI * E. This transaction Is to replace a principal residence by a person 55 years of age or older. <br />Within the same county? ❑ YES ❑ NO <br />❑ ® * F. This transaction Is to replace a principal residence by a person who is severely disabled. <br />Within the same county? D YES ❑ NO <br />❑ TI G. This transaction is to replace a principal residence substantially damaged or destroyed by a wildfire or natural disaster for which <br />the Governor proclaimed a state of emergency. Within the same county? ❑ YES ❑ NO <br />❑ EI H. 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 />❑ El I. The recorded document creates, terminates, or reconveys a lender's interest In the property. <br />❑ KI J. 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 />❑ 71 K. The recorded document substitutes a trustee of a trust, mortgage, or other similar document. <br />L. This Is a transfer of property: <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 />❑ IE 2, to/from an Irrevocable trust for the benefit of the <br />❑ creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantor'sitrustor's registered domestic partner. <br />❑ EI M. This property is subject to a lease with a remaining lease term of 35 years or more Including written options, <br />❑ El N. This Is a transfer between parties in which proportional Interests of the transferor(s) and transferee(s) In each and every parcel being <br />transferred remain exactly the same after the transfer. <br />❑ El O This is a transfer subject to subsidized low -Income housing requirements with governmentally Imposed restrictions, or restrictions <br />imposed by specified nonprofit corporations. <br />❑ ®* P This transfer Is to the first purchaser of a new building containing an active solar energy system. <br />❑ M O. Other. This transfer Is to <br />* Please refer to the Instructions for Part 1. <br />Please provide any other Information that will help the Assessor understand the nature of the transfer. <br />THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION <br />SFRM0017 (DSI Rev. 02118121) <br />