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NAME AND MAILING ADDRESS (Make necessary c orrections to t he printed name and mailing address) If yes, percentage transferred If yes, which unit was the transferor's principal residence? Cultivation: DATE OF DECREE OF DISTRIBUTION (if applicable) PROBATE NUMBER (if applicable) RECORDER'S DOCUMENT NUMBER DATE OF DEATH (if applicable) DATE OF PURCHASE OR TRANSFER CITY PROPERTY ADDRESS ASSESSOR'S PARCEL/ID NUMBER Relationship Name Relationship Name EMAIL ADDRESS CITY, STATE, ZIP DAYTIME PHONE NUMBER ( ) MAILING ADDRESS DATE PRINTED NAME DATE PRINTED NAME CLAIM FOR REASSESSMENT EXCLUSION FOR TRANSFER BETWEEN GRANDPARENT AND GRANDCHILD OCCURRING ON OR AFTER FEBRUARY 16, 2021 BOE-19-G (P1) REV. 05 (07-25) A. PROPERTY B. TRANSFEROR(S)/SELLER(S) (additional transferors, please complete Section E on Page 3) Print full name(s) of transferor(s) Family relationship(s) to transferee(s) 1. Was this property the transferor's family f arm? If yes, how is the property used? Pasture/Grazing Agricultural Commodity No 2. Was this property the transferor's p rincipal residence? No Yes Yes a. If yes, please check which of the following exemptions was granted or eligible to be granted on this property: Homeowners' Exemption Disabled Veterans' Exemption b. Is this property a multi-unit property? No Yes 3. Was only a p artial interest in the property transferred? No Yes 4. Was this property owned in joint tenancy? Yes No 5. Print name(s) of all child(ren) of grandparents who is(are) the parent(s) of grandchild: IMPORTANT: If the transfer was through the medium of a will and/or trust, you must attach a full and complete copy of the will and/or trust and all amendments. CERTIFICATION I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information herein, including any accompanying statements or materials, is true, correct, and complete to the best of my knowledge and belief and that I am the grandparent or grandchild (or transferor's legal representative) of the transferees listed in Section D. I knowingly am granting this exclusion and will not file a claim to transfer the base year value of my principal residence under Revenue and Taxation Code sections 69, 69.3, or 69.6. SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE SIGNATURE OF TRANSFEROR OR LEGAL REPRESENTATIVE (Please complete information on reverse side.) THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION Donald O'Connor Alpine County Assessor/Recorder PO Box 155 Markleeville, CA 96120 Ph: (530) 694-2283 ---PAGE BREAK--- e. Date the transferee occupied this property as a principal residence: (month/day/year) c. Name of transferee who filed or will be filing exemption claim: Date of death: Date of marriage/domestic partnership registration: c. Had the surviving spouse/partner remarried or entered into a registered domestic partnership? Date of death of direct descendant: 2. Parent: Name of direct descendant of grandparent who is the parent of the grandchild: Adopted by whom? 1. If grandchild was a dopted, age at time o f adoption? Relationship Relationship Name Name MOVE-OUT DATE (month/day/year) CITY, STATE, ZIP COUNTY ADDRESS ASSESSOR'S PARCEL/ID NUMBER EMAIL ADDRESS CITY, STATE, ZIP DAYTIME PHONE NUMBER ( ) MAILING ADDRESS DATE PRINTED NAME PRINTED NAME BOE-19-G (P2) REV. 05 (07-25) C. GRANDPARENT/GRANDCHILD RELATIONSHIP INFORMATION (Please provide copy of death certificate) a. Was the deceased parent married or in a registered domestic partnership ("registered" means registered with the California Secretary of State) as of the date of deat h? Yes No b. Is the spouse or registered domestic partner of the deceased parent a: (check one) Parent of the grandchild ( g o to question Stepparent of the grandchild (a stepparent need not be deceased) (go to section Yes No If yes, date of marriage or registration of the domestic partnership must have occurred prior to the date of purchase or transfer to qualify for exclusion. (Please provide copy of license or registration) If no, surviving spouse/partner is still considered a child of grandparents and must also be deceased prior to the purchase or transfer to qualify for exclusion. (Please provide copy of death certificate) D. TRANSFEREE(S)/BUYER(S) (additional transferees please complete Section F on Page 3) Print full name(s) of transferee(s) Family relationship(s) to transferor(s) 1. Is this property the transferee's family farm? Yes No 2. Is this property currently the transferee's principal residence? If yes, complete section a, b, c, d, e, and f below: If no, date the transferee intends to occupy the property as the principal residence: No Yes a. Is this property a multi-unit property? If yes, unit that is the transferee's principal residence: No Yes b. Has the transferee applied for a Homeowners' or Disabled Veterans' Exemption? Yes If yes, complete sections c, d, e, and f. If no, to be eligible for the exclusion, the transferee must file and be eligible for one of the exemptions within one year of the transfer date. If the exemption claim is filed after the one-year period, prospective relief may be available . No d. Type of Exemption: Disabled Veterans' Exemption Homeowners' Exemption f. Does the transferee o wn another property that is or was their principal residence i n California? Yes If yes, please provide the address below and the move-out date. No CERTIFICATION I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information herein, including any accompanying statements or materials, is true, correct, and complete to the best of my knowledge and belief and that I am the grandparent or grandchild (or transferee's legal representative) of the transferors listed in Section B. SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVE DATE SIGNATURE OF TRANSFEREE OR LEGAL REPRESENTATIVE Note: The Assessor may contact you for additional information. THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION ---PAGE BREAK--- BOE-19-G (P3) REV. 05 (07-25) E. ADDITIONAL TRANSFEROR(S)/SELLER(S) PRINT NAME RELATIONSHIP TO TRANSFEREE F. ADDITIONAL TRANSFEREE(S)/BUYER(S) PRINT NAME RELATIONSHIP TO TRANSFEROR THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION ---PAGE BREAK--- BOE-19-G (P4) REV. 05 (07-25) CLAIM FOR REASSESSMENT EXCLUSION FOR TRANSFER BETWEEN GRANDPARENT AND GRANDCHILD OCCURRING ON OR AFTER FEBRUARY 16, 2021 Revenue and Taxation Code Section 63.2 Property Tax Rule 462.520 For transfers occurring on or after February 16, 2021, section 2.1(c) of article XIII A of the California Constitution, implemented by Revenue and Taxation Code section 63.2, provides that the terms "purchase" or "change in ownership" do not include the purchase or transfer of a family home or family farm between grandparents and their grandchildren. To qualify for this exclusion, all parents of the grandchild, who qualify as children of the grandparents, must be deceased as of the date of the grandparent-grandchild transfer. A stepparent does not need to be deceased. For purposes of this exclusion, a grandchild is a child of the child of the grandparent. A "child" means any of the following: • A child born of the parent, except a child who has been adopted by another person. • A stepchild, while the relationship of stepparent and stepchild exists. • An in-law child, while the in-law relationship exists. • A child adopted by the parent pursuant to statute, other than an individual adopted after reaching 18 years of age. • A foster child of a state-licensed foster parent. A family home must have been the principal residence of the transferor and must continue or become the principal residence of the transferee within one year of the date of transfer or change in ownership. For real property that is sold or gifted, the date of recording of the deed is presumed to be the date of transfer or change in ownership. For real property that is inherited via trust, will, or intestate succession, date of death is the date of change in ownership. For a family home, the transferee must file for the homeowners' or disabled veterans' exemption within one year of the date of transfer or change in ownership. If the exemption claim is filed after the one- year period, prospective relief may be available. A family farm is any real property that is under cultivation or being used for pasture or grazing, or that is used to produce any agricultural commodity. "Agricultural commodity" means any and all plant and animal products produced in this state for commercial purposes, including, but not limited to, plant products used for producing biofuels, and cultivated industrial hemp (Government Code section 51201). If the assessed value of the family home or each legal parcel of a family farm on the date of transfer exceeds the sum of the factored base year value plus $1 million, the amount in excess of this sum will be added to the factored base year value. Beginning February 16, 2023 and every other February thereafter, the $1 million amount will be adjusted by the percentage change in the Housing Price Index for California for the previous calendar year, as determined by the Federal Housing Finance Agency. For further information, please see the State Board of Equalization's website at www.boe.ca.gov/prop19. Exclusion filing requirements: • For a family farm, this claim form must be completed, signed by the transferor(s) and the transferee, and filed with the Assessor. • For a family home, this claim form must be completed, signed by the transferor(s) and the transferee, and filed with the Assessor; and an eligible transferee must file for the homeowners' or disabled veterans' exemption within one year of the date of transfer or change in ownership. This claim form is timely if it is filed within three years after the date of purchase or transfer or prior to the transfer of the real property to a third party, whichever is earlier. If a claim form has not been filed by the date specified in the preceding sentence, it will be timely if filed within six months after the date of mailing of a notice of supplemental or escape assessment issued as a result of the purchase or transfer for which this claim is filed. If either claim is not timely filed, prospective relief may be available. This claim form is for transfers occurring on or after February 16, 2021. For transfers occurring on or before February 15, 2021, please file claim form BOE-58-G, Claim for Reassessment Exclusion for Transfer from Grandparent to Grandchild. NOTE: A county board of supervisors may authorize a one-time processing fee of not more than $175 to recover costs incurred by the County Assessor due to the failure of an eligible transferee to file a claim for the grandparent-grandchild change in ownership exclusion after two written requests have been sent to an eligible transferee by the County Assessor. THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION