Microsoft Word - RPR Instructions (11.29.2016)

AD/App.12A (Rev. 7/3/2023)

1 of 4 www.ladbs.org

CityofLosAngeles,DepartmentofBuildingandSafety(LADBS)

INSTRUCTIONSFORCOMPLETINGTHEAPPLICATIONFORREPORTOF

RESIDENTIALPROPERTYRECORDSANDPENDINGSPECIALASSESSMENTLIENS

A. Ensure that the property address is in the City of Los Angeles.

Make this deter

mination befo

re submitting the Application to us for processing.

Consult a recent version of the

Thom

as Guide to verify that the property for which this report is being sought is in the City of Los Angeles (

the

pro

perty should be in the white sections of the Thomas Guide

), or check to see if the seller has a current LADWP bill.

Please be advised that if any work is/was performed on your report, you may not be entitled to a refund, per

L.A.M.C. Sec. 22.12, 22.13. This includes but is not limited to duplicate requests and canceled requests.

B. A separate application and fee must be submitted for each parcel.

It is rare that a property co

ntains more than one parcel.

C. Complete the following fields on the Application.

1. Assessor Number from County Tax Bill, Escrow Number, and Post Office City: (Area 1 of Application)

 Assessor’s Number: Consists of a Map Book, Page, and Parcel number. Submit one Assessor Number

per report. Each condominium unit, or parcel or legally-tied parcels being sold require a separate report

and fee.

 Escrow Number: Provide the escrow number, if applicable.

 Community Name: Provide the Community Name: (e.g. Hollywood) of the property, if known.

2. Street Address and Description of Property Being Sold: (Area 2

of Application)

Multiple lines are provided to indicate multiple address information along with the associated property

description.

 Street Address: Include the street beginning number, street ending number (if applicable), and street

name and type (such as Ave, Blvd, Pl, St). Provide the condominium unit number when the property being

sold is a condominium.

 Description of Property Being Sold: Indicate whether the property being sold is a vacant lot, or has

either a one-family dwelling or specify other type of structure(s) on the property.

3. Legal Description of Property as Shown on Grant Deed: (Area 3 of Application)

 Tract, Block, Lot: The legal description will always contain a tract, but may not have a block or lot.

Attach a copy of the legal description when it is a metes and bounds (measured boundaries) or is complex

in nature.

4. Mail Co

pleted Report To and Person to Contact for Additional Information: (Area 4 of Applic

ation)

 Mail Completed Report To: Indicate the name, address and email where the completed report should be

mailed.

 Person to Contact for Additional Information: Provide a person’s name and phone number that can be

contacted for additional inf

ormation. If applicable, also include an e-mail address.

5. Complete and Include the Declarations Attachment: (Area 5 of A

plication)

 The Declarations Attachment cannot be reworded or altered in any manner, and must contain the signature

of the owner and buyer, and proof of ownership as applicable. Legibly print the name of the person, not

the company name, in the owner’s and/or buyer’s signature block.

D. ENCLOSE A CHECK OR MONEY ORDER FOR $70.85. Do not send cash. Only pre-printed checks will be

accepted. Make check or money order payable to: DEPARTMENT OF BUILDING AND SAFETY.

E. Mail the completed Application, the signed Declarations Attachment, and payment to:

DEPARTMENT OF BUILDING AND SAFETY

201 NORTH FIGUEROA

STREET, 4TH FLOOR, “CASHIER”

LOS ANGELES, CA 90012-2623

F. If you have any questions, please contact us at (213) 482-6777.

As a covered entity under Title II of the Americans with Disabilities Act, the City of Los Angeles does not discriminate on the basis of disability,

and upon request, will provide reasonable accommodation to ensure equal access to its programs, services and activities.

AD/App.12A (Rev. 7/3/2023)

2 of 4 www.ladbs.org

CityofLosAng

eles‐DepartmentofBuildingandSafety

APPLICATIONFORREPORTOFRESIDENTIALPROPERTYRECORDS

ANDPENDINGSPECIALASSESSMENTLIENS

INSTRUCTIONS:

Please complete all areas of the application and mail or deliver a check (ONLY PRE-PRINTED CHECKS WILL BE ACCEPTED) or money order for $70.85,

payable to “DEPARTMENT OF BUILDING AND SAFETY”, to CASHIERS, 4TH FLOOR, 201 N. FIGUEROA ST., LOS ANGELES, CA 90012. DO NOT MAIL

CASH – cash is only accepted in person. A separate application must be submitted and a fee paid for each parcel. For questions call 311 or (213) 473-3231.

NOTE:

Please be sure that the property address is in the City of Los Angeles before mailing this form. You may verify this by consulting a current Thomas

Guide. Should any work be performed on your report, you may not be entitled to a refund per L.A.M.C. Sec. 22.12 and 22.13.

ASSESSOR NUMBER FROM COUNTY TAX BILL

ESCROW NO. COMMUNITY NAME

MAP BOOK PAGE PARCEL

STREET ADDRESS DESCRIPTION OF PROPERY BEING SOLD

(Select one for each address listed)

STREET

NO.

STREET NAME, TYPE (BLVD, AVE, ST, PLACE, ETC.),

AND UNIT/APARTMENT NUMBER

1-FAMILY

DWELLI

2-FAMILY

DWELLING

PT.

CONDO VACANT

LOT

OTHER (Specify &

include no. of units)

LEGAL DESCRIPTIONS OF PROPERTY AS SHOWN ON GRANT DEED

(Attach any long legal descriptions and include a copy of the title insurance policy map to this application.)

TRACT BLOCK LOT

LEGAL

ATTACHED?

YES

MAIL COMPLETED REPORT TO:

ADDRESS EMAIL

(Select one option from the above)*

PERSON TO CONTACT FOR ADDITIONAL INFORMATION

NAME

DDRESS

CITY STATE ZIP

PLEASE COMPLETE AND INCLUDE THE DECLARATIONS ATTACHMENT

L.A.M.C. Section 151.00 requires all owners whose rental units are subject to the Rent Stabilization Ordinance to

registration has been obtained. Contact the Division at (866) 557-7368.

Section 96.300 L.A.M.C. requires that the seller of Residential Propert

within the City of Los Angeles shall apply to

the City for a Report of Residential Property Records and Pending Special Assessment Liens and deliver such report

to the buyer prior to entering into an agreement of sale or exchange of the Residential Property or prior to close of

escrow in connection therewith. There is a fee of $70.85 for this service.

Residential Property is defined as:

a. Any real property improved with one or more buildings or structures which in whole or in part are used for or

are legally permitted to be used for dwelling unit or guest room purposes.

b. Any vacant real property located in a zone wherein dwelling units or guest rooms are legally permitted.

FOR CASHIER’S USE ONLY

A report is not required in the following cases:

1. Property exempt from taxation under the Documentary Transfer Act of the State of California.

2. The first sale of a residential building located in a subdivision whose final map has been approved and recorded

in accordance with the Subdivision Map Act not more than two years prior to the first sale (except for

condominium conversions).

No new Report need be obtained by an owner for a period of six months after the issuance of a Report on a

Residential Property. However, the seller must still deliver a copy of the previously issued Report to the buyer prior to

the sale or exchange of the Residential Property or prior to close of escrow.

*If both the mail-out options are selected, the report will only b

e emailed t

o the provided email address.

NAME PHONE NUMBER

EMAIL ADDRESS

AD/App.12A (Rev. 7/3/2023)

3 of 4 www.ladbs.org

2-Family

Dwelling

1-Family

Dwelling

CityofLosAngeles‐DepartmentofBuildingandSafety

REPORTOFRESIDENTIALPROPERTYRECORDSDECLARATIONS

ATTACHMENT

(PerSec.22.12,22.13L.A.M.C.,refundsarenotgrantedforareportwhereANYworkhasbeendoneonthe

report.)

PROJECT ADDRESS ASSESSOR’S ID

Description of property being so

ld:

Apartment Condo Vacant Lot Other

The Owner must complete i

tem B in Section I for all reports. If the owner cannot complete all declarations under item A of

Section I, the Buyer must complete Section “II. Buyer’s Declaration”. Check only one box under each number.

I. OWNER’S DECLARATION:

I, as owner, declare under penalty of perjury that the following statements are true and correct for the residential building for which

this report is sought.

A. The following device(s) and/or material have been or will be installed as in

dicated below.

1) Water conservation devices

a) Have been installed.

Will be installed in compliance with Section 122.03 Los Angeles Municipal Code (L.A.M.C.).

***Water Conservation Certificate of Compliance, as specified in L.A.M.C. Section 122.03, must be filed prior to the close of escrow with the Department

of Water and Power (LADWP). A Certificate of Compliance form may be obtained by calling LADWP at (800) 544-4498.***

2) Security Lighting and Locks

a) Have been installed.

Will be installed in compliance with Section 91.8607 L.A.M.C.

The Security Lights and Locks Ordinance does not apply since no apartment building (3 or more units) is currently

present on the property for which this report is being sought.

3) Seismic Gas Shut-Off Valves (SGSOV) or Excess Flow Shut-Off Valve (EFSOV)

a) Have been installed.

Will be installed in compliance with Section 94.1217 L.A.M.C.

The Gas Shut-off Valves Ordinance does not apply since no gas fuel lines are provided for any building on the property

for which this report is being sought.

4) Metal bars, grills, grates, security roll-down shutters, and similar devices installed over emergency escape windo

ws in

sleeping rooms.

a) Have been installed.

Will be installed in accordance with Section 91.1029 L.A.M.C.

Are not installed.

5) Smoke and Carbon Monoxide Detectors

a) Have been installed.

Will be installed in compliance with Section 91.8603 L.A.M.C.; Section 91.420.6.2.3 L.A.M.C.

6) Impact Glazing/Approved Film for sliding glass panels of sliding-type doors

a) Have been installed.

Will be installed in compliance with Section 91.6101; Section 96.302 L.A.M.C.

The Impact Hazard Glazing Ordinance does not apply.

Further, I (owner) certify that smoke detectors in compliance with Section 91.8603 L.A.M.C. and carbon monoxide detectors in

compliance with Sect

ion 91.420.6.2.3 L.A.M.C. and impact glazing/approved film for sliding glass panels of sliding-type doors in

compliance with Section 91.6101; Section 96.302 L.A.M.C. will be installed prior to entering into an agreement of sale or

contracting for an exchange of said residential property, or, where an escrow agreement has been executed in connection therewith,

prior to close of escrow, and that within 10 days after installation, I will so advise the Department of Building and Safety in writing

to Residential Property Records, c/o Cashier, 201 N. Figueroa St., 4th Floor, Los Angeles, CA 90012-4869.

B. 1)

I have inspected the property being sought and no protected trees are located on this property.

I have inspected the property for the existence of protected trees. (For the purpose of this declaration the definition of

“protected trees” set forth in L.A.M.C. Section 46.01 shall apply.) The number of protected trees identified as located on

this property is_______.

I authorize the Department of Building and Safety to verify this information by entry upon the subject property. I understand that a

fee, as specified in L.A.M.C Section 98.0412(a), shall be collected by the Department of Building and Safety for any inspection

required to verify this declaration.

Signature of Owner ________________________________ Print Name ________________________________ Date ____________

AD/App.12A (Rev. 7/3/2023)

4 of 4 www.ladbs.org

CityofLosAngeles‐DepartmentofBuildingandSafety

REPORTOFRESIDENTIALPROPERTYRECORDSDECLARATIONS

ATTACHMENT

(PerSec.22.12,22.13L.A.M.C.,refundsarenotgrantedforareportwhereANYworkhasbeendoneonthe

report.)

PROJECT ADDRESS ASSESSOR’S ID

II. BUYER’S

DECLARATION:

I, as buyer, declare under penalty of perjury that the following statements are true and correct for the residential building for which

this report is sought.

A. The following device(s) and/or material have been or will be installed as indicated below.

1) Water conservation devices

a) Have been installed in compliance with Section 122.03 Los Angeles Municipal Code (L.A.M.C.).

2) Security Lighting and Locks

a) Have been installed in compliance with Section 91.8607 L.A.M.C.

The Security Lights and Locks Ordinance does not apply since no apartment building (3 or more units) is currently

present on the property for which this report is being sought.

3) Seismic Gas Shut-Off Valves (SGSOV) or Excess Flow Shut-Off Valve (EFSOV)

a) Have been installed in compliance with Section 94.1217 L.A.M.C.

Will be installed in compliance with Section 94.1217 L.A.M.C., prior to entering into an agreement of sale or prior to

the close of escrow when an escrow agreement has been executed in connection with the sale; and that within 10 days

after installation, Buyer will so advise the Department of Building and Safety in writing to Residential Property Records,

c/o Cashier, 201 N. Figueroa St., 4th Floor, Los Angeles, CA 90012-4869. Failure to comply with this requirement

shall subject the buyer to the payment of a noncompliance fee in addition to the other penalties provided by law.

The Gas Shut-off Valves Ordinance does not apply since no gas fuel line is provided for any building on the property

for which this report is being sought.

4) Metal bars, grills, grates, security roll-down shutters, and similar devices installed over emergency escape windo

ws in

sleeping rooms

a) Have been installed in accordance with Section 91.1029 L.A.M.C. for the property for which this report is being

sought.

Are not installed.

5) Smoke and Carbon Monoxide Detectors

a) Will be installed in compliance with Section 91.8603 L.A.M.C.; Section 91.420.6.2.3 L.A.M.C.

6) Impact Glazing/Approved Film for sliding glass panels of sliding-type doors

a) Will be installed in compliance with Section 91.6101; Section 96.302 L.A.M.C.

Impact Hazard Glazing Ordinance does not apply.

Further, smoke detectors in compliance with Section 91.8603 L.A.M.C. and carbon monoxide detectors in compliance with

Section 91.420.6.2.3 L.A.M.C. and impact glazing/approved film for sliding glass panels of sliding-type doors in compliance with

Section 91.6101; Section 96.302 L.A.M.C. will be installed by Buyer within 30 days after entering into an agreement of sale or

contracting for an exchange of said residential property, or, where an escrow agreement has been executed in connection therewith,

within 30 days after the close of escrow, and that within 10 days after installation, will so advise the Department of Building and

Safety in writing to Residential Property Records, c/o Cashier, 201 N. Figueroa St., 4th Floor, Los Angeles, CA 90012-4869.

Signature of Buyer ________________________________ Print Name ________________________________ Date ____________

Section 96.300 L.A.M.C. requires that the seller of Residential Property within the City of Los Angeles shall apply to the City for a

report of Residential Property Records and Pending Special Assessment Liens (aka Form 9) and deliver such report to the buyer prior

to entering into an agreement of sale or exchange of the Residential Property or prior to close of escrow in connection therewith. Refer

to the Forms section at this website for submitting a paper application or our Online service Residential Property Report System for

submitting a request for RPR using the internet.

For more information regarding the Los Angeles Municipal Code and Ordinance requirements when selling residential and commercial

property for existing single or two family dwellings, condominiums and apartments, please refer to the Los Angeles Department of

Building and Safety website at: http://ladbs.org/LADBSWeb/requirements-selling-property.jsf