Stamps.com 2011 Annual Report Download - page 114

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STATEMENT OF TAX DUE AND REQUEST
THAT TAX DECLARATION NOT BE MADE A PART
OF THE PERMANENT RECORD
IN THE OFFICE OF THE
COUNTY RECORDER
(Pursuant to Cal. Rev. & Tax. Code Section 11932)
County of ____________________
Request is hereby made in accordance with the provisions of the Documentary Transfer Tax Act that the amount of tax due not be
shown on the original document which names:
as Grantor
and
as Grantee.
The property described in the accompanying Grant Deed is located in the City of ________________, County of _______________,
State of __________________.
The amount of tax due on said document is $ ______________________
EXHIBIT B
Document
No.
Date Recorded:
To
Registrar
-
Recorder
COMPUTED ON FULL VALUE OF PROPERTY CONVEYED
COMPUTED ON FULL VALUE LESS LIENS AND ENCUMBRANCES REMAINING AT TIME OF SALE
SIGNATURE OF DECLARANT OR AGENT\
5