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�pF 5flq. <br />County of San Mateo <br />U TRANSFER TAX AFFIDAVIT <br />r6+rnv r. <br />Per San Mateo County Ordinance Code 2.93.050 <br />NOTICE: Any material misrepresentation of fact in this <br />affidavit is a misdemeanor under section <br />2.93.120 of the San Mateo County real property tax <br />code. Any person who makes such a representation is <br />subject to prosecution for such offense. <br />The Assessor -Clerk -Recorder reserves the right to report <br />potentially fraudulent recordings to the District Attorney's <br />Real Estate Fraud Unit. <br />DTT AFFIDAVIT <br />This form must accompany any document that <br />requires a Documentary Transfer Tax <br />declaration, including but not limited to; <br />Agreement for Sale; Assignment of Lease; <br />Deed in Lieu of Foreclosure; Easement; Grant <br />Deed; Land Contract; Lease; Memorandum of <br />Lease; <br />1. LOCATION OF PROPERTY: Assessor's Parcel Number: 057-221.100 and 057-221-110 and City: Redwood City <br />057-222-240 and 057-222-250 and <br />057-222-260 and 057-222-270 and <br />057-222-280 and 057-222-290 and <br />057-222-300 <br />Vacant Land/ APN 057-221-100, 057-221-110, 057-222-240, <br />057-222-250, 057-222-260, 057-222-270, 057-222-280, <br />Street Address: 057-222-290 £t 057-222-300, Redwood City, CA Document To Be Recorded: <br />2. IS THIS A FORECLOSURE OR TRUSTEE SALE? ❑ Yes Cg, No (If yes, complete this section.) <br />a. Is the transferee the Beneficiary or Mortgagee? ❑ Yes X No <br />b. Please provide. Name of Trustee: <br />Date of original Deed of Trust: <br />3. IS THIS A LEASE? ❑ Yes EC No (If yes or no, complete this section.) <br />a. Is remaining term of lease, including renewal options, greater than 35 years? ❑ Yes lx No <br />b. If NO, submit a copy of the lease, or summary, or terms. <br />c. If YES, enter the value of the lease interest on line 9a. (For tax calculations.) <br />4. IS THIS A GIFT IN WHOLE OR IN PART? EXYes ❑ No (If yes, give a complete explanation.) <br />Mel Casey and Marguerite Casey and The Casey Family <br />Name of the Donor: Trust created by them on May 10, 2000 <br />Name of the Donee: City of Redwood <br />whole <br />Please be aware that certain gifts in excess of $15,000 per calendar year may trigger a Federal Gift Tax. In such <br />cases, the Transferor/ Donor may be required to fill out a Form 709 (Federal Gift Tax Return) with the Internal <br />Revenue Service. Please also be aware that the information stated on this document may be given to and used by <br />governmental agencies, including the Internal Revenue Service. <br />1, as the Transferor/Donor declare under penalty of perjury that 1 have read the above paragraph and <br />acknowledge that a Federal Gift Tax may be triggered. <br />Mel Casey and Marguerite Casey and 650-274-5281 <br />The Casey Family Trust created by <br />them on May 10. 2000 <br />Signature of uonor: Print uonor Name: Donor Phone: <br />SIGNATURE ON REVERSE STILL REQUIRED. <br />5. ARE YOU ADDING OR REMOVING A CO-OWNER FOR REFINANCING PURPOSES? ❑ Yes C.$ No <br />If yes, initial to the right to indicate your agreement with the statement below and sign on reverse. <br />Initial here: <br />The proportional ownership interest will revert back to its original holding within one (1) month from the date of <br />recording; otherwise 1 will pay the applicable transfer tax. <br />