Recording requested by (name):
____________________________________________ 
When recorded mail to
and mail tax statements to ___________________________________________  
___________________________________________ 
___________________________________________ 
___________________________________________ 
	For recorder’s use	

AFFIDAVIT – DEATH OF TRANSFEROR (TOD DEED)
Assessor’s Parcel No. (APN): 
_____________________________	Declaration of Exemption From GC § 27388.1 Fee
 Transfer is exempt from fee per GC § 27388.1(a)(2):
     Transfer is subject to Documentary Transfer Tax    
     Transfer of residential dwelling to owner-occupier
 Transfer is exempt from fee per GC 27388.1(a)(1):
     $225.00 fee cap      Not related to real property	
_____________________________, of legal age, being first duly sworn, deposes and says: 

_____________________________, the decedent mentioned in the attached certified copy of Certificate of Death, is the same person as _____________________________, the transferor under the Revocable Transfer on Death Deed dated __________ and recorded on __________ as Instrument No. ____________________, in Book/Reel __________. Page/Image __________, of the Official Records of _____________________________ County, California, which named as beneficiary(ies) ____________________________________________________________________ 
_________________________________________________________________________________ 
and which transferred the following described property in  ___________________________________ County, California (insert legal description): ______________________________________________ 
_________________________________________________________________________________ 
_________________________________________________________________________________ 
_________________________________________________________________________________ 

NOTICE TO HEIRS: 
I, _____________________________, served the notice required by Probate Code Section 5681.

Date: ________	_______________________________________ 
	(Signature of declarant)

	_______________________________________ 
	Type or print name