Change In Ownership Statement Death Of Real Property Owner
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2BOE-502-D (P1) REV. 08 (05-14)
DENNIS DRAEGER
ASSESSOR-RECORDER-COUNTY CLERK
CHANGE IN OWNERSHIP STATEMENT
COUNTY OF SAN BERNARDINO
DEATH OF REAL PROPERTY OWNER
ASSESSOR'S OFFICE
172 West Third Street
This notice is a request for a completed Change in
San Bernardino, CA 92415-0310
Ownership Statement. Failure to file this statement will
result in the assessment of a penalty.
(909) 387-8307 - 1-877-885-7654
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address)
Section 480(b) of the Revenue and Taxation Code requires that
the personal representative file this statement with the Assessor
in each county where the decedent owned property at the time of
death. File a separate statement for each parcel of real property
owned by the decedent.
NAME OF DECEDENT
DATE OF DEATH
Did the decedent have an interest in real property in this county? If YES, answer all questions. If NO, sign and
YES
NO
complete the certification on page 2.
STREET ADDRESS OF REAL PROPERTY
CITY
ZIP CODE
ASSESSOR’S PARCEL NUMBER (APN)*
*If more than 1 parcel, attach separate sheet.
R
R
DESCRIPTIVE INFORMATION
DISPOSITION OF REAL PROPERTY
(IF APN UNKNOWN)
Decree of distribution
Copy of deed by which decedent acquired title is attached.
Succession without a will
pursuant to will
Copy of decedent’s most recent tax bill is attached.
Probate Code 13650 distribution
Action of trustee pursuant
Deed or tax bill is not available; legal description is attached.
Affidavit of death of joint tenant
to terms of a trust
R
TRANSFER INFORMATION
Check all that apply and list details below.
Decedent’s spouse
Decedent’s registered domestic partner
Decedent’s child(ren) or parent(s.) If qualified for exclusion from assessment, a Claim for Reassessment Exclusion for Transfer
Between Parent and Child must be filed (see instructions).
Decedent’s grandchild(ren.) If qualified for exclusion from assessment, a Claim for Reassessment Exclusion for Transfer from
Grandparent to Grandchild must be filed (see instructions).
Cotenant to cotenant. If qualified for exclusion from assessment, an Affidavit of Cotenant Residency must be filed (see
instructions).
Other beneficiaries or heirs.
A trust.
NAME OF TRUSTEE
ADDRESS OF TRUSTEE
List names and percentage of ownership of all beneficiaries or heirs:
NAME OF BENEFICIARY OR HEIRS
RELATIONSHIP TO DECEDENT
PERCENT OF OWNERSHIP RECEIVED
This property has been or will be sold prior to distribution. (Attach the conveyance document and/or court order).
NOTE: Sale of the property does not relieve the need to file a Claim for Reassessment Exclusion for Transfer Between Parent
and Child if appropriate.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
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