Loading...
HomeMy WebLinkAboutReal Estate Excise Tax Affidavit • ir REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt when stamped ,. PLEASE TYPE OR PRINT } by cashier. • Form No. 84 0001A CHAPTER 82.45 RCW - CHAPTER 458-61 WAG- " For Use at County Treasurer's Office • (Use Form No. 84-000IB for Reporting Transfers of Controlling Interest of Entity Ownership to the Department of Revenue) . THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL ITEMS ARE FULLY COMPLETED Hayden Vey i,.l. .,S. "',.,. g.�.o,pm,en_ ® Jetjtiexeon County Name •tt"'t Name . • �z r.u. :tsox lb . . zF Pao. Box' 1220 - -9 Street - -Z Street - . x Pt. Ludlow WA 98365 mz Pt. Townsend WA 98368 o City State Zip c City - State Zip ©ADDRESS TO SEND ALL PROPERTY TAX RELATED CORRESPONDENCE ALL TAX PARCEL NUMBERS COUNTY TREASURER PLACE -'. ASSESSED VALUE IF TAX gNEM17: i same as above (grantee) ptn -.901 111 005 11 Name Street .. .,_ . a ... .. City/State - Zip f(1L-EGAL DESCRIPTION OFI PROPE�2TY'SITUATED IN'®°UNINCORPORATED�LL'Lief f ei sc0UNTY.ra549 F4141GIVP61/+eeaa=m'=141 Street Address (if property is improved): - - - -- -- All that portion of the North 524.75 feet of Southwest 1/4 of the Northeast 1/4 of Section 11, Township 29 North, Range 1 West, W.M., and the Northwest 1/4 of the Northeast 1/4 of said Section described as follows:._ Beginning at the intersection of the centerline of the Chimacum Road, County Road Number 932507, and the north line extended of the tract conveyed by the Boundary Line Adjustment recorded under I n® Auditor's File Number 344682, and shown in the Record of Surveys on Page 64 of Volume 13;thence I' westerly along said north line extended to the intersection of a line parallel and 40 feet westerly of • said centerline; thence southerly along said parallel line to the beginning of a tangent curve concave Iture, northwesterly having a radius of 50 feet, said beginning being 110.49 feet northerly along said parallel I line extended southerly, of the South Line of said North 524.75 feet of said Southwest 1/4 of the Northeast 1/4; thence along said curve-a distance of 64.54 feet to a tangent line being parallel with . 1 said south line; thence westerly along said tangent line a distance of 96.84 feet, more or less, to the westerly .right of way of the Old Hadlock Road, County Road Number 527109; thence southerly along said westerly right of way to the South Line of the said North 524.75 feet of said Southwest• 1/4 of the Northeast 1/4; thence easterly along-said South Line to the centerline of said Chimacum I Road; thence northerly along said centerline to the said north line extended and the point of beginning. The parcel of land being conveyed nnntaininc 0.793 acree more or Ines; less existing right of way of 0 450 1 acres, more or less: used btitiamg _.... _. ._ .._ .. .. 9-9 v93 - _ ")- -Date of..Document-'— - .._ .,�... _ , _._ 0 fl (I) NOTICE OF CONTINUANCE (RCW 84.33 or RCW 84.34) Gross Sale Price $ If the new owner(s) of land that is classified or designated as current use Personal Property (deduct) $ 0 or forest land wish.to continue the classification or designation of such land, Taxable Sale Price $ O the new owner(s) must sign below. If the new owner(s) do not desire to 0 continue such classification or designation, all compensating or additional Excise Tax State $ 0 tax calculated pursuant to RCW 84.33.120 and 140 or RCW 84.34.108 shall Local - $ 0 be due and payable by the seller or transferor at the time of sale.The county _ Delinquent Interest: State • $ r:. assessor must determine if the land transferred qualifies to continue - Local $ . 0 ; classification or designation and must so indicate below. Signatures do not 0 • necessarily mean the land will remain in classification or designation.,If; _,,,c.Dclinqucnt.11',enalty: State $ u t it no longer qualifies, it will be removed and the compensating taxes will Total Due 4 $ be applied. All new owners must,sign".+,. THERE IS A $2.00 FEE FOR PROCESSING THIS FORM IF NO TAX IS DUE. E This land ❑ does ❑ does not qualify for continuance. ® AFFIDAVIT • F Date "' ' I certify under penalty of perjury_under the laws.of the state of DEPUTY ASSESSOR Washington that4the foregoing is true and correct. (2) NOTICE OF COMPLIANCE (Chapter 84.26 RCW) _ • j.Xcu'ftothu` ',UJ+.-Z"/; C. •�fer'6' ^' I Signature of n k u-, 1 l (-tit-0-t-t.ce— ,r- ! I If the new owner(s)of property with special valuation as historic property Grantor Agent X -( �1 1 ,i h.— A- it t r✓F J/t'• e f` I wish to continue this special valuation the new owner(s) must sign.below. r _ y, // E PU. 1 i Ii_C '-" If the new owner(s) do not desire to continue such,special valuation;,all Name (print)- , +:-It rc' /'!'\ .�. ,4a_-G.L_- additional tai:-calculated pursuant to'Ckaptcr 84.26 RCW;shall be due and - '-" • -l-•' ' -':Ay -i.%. "-''/ - ' - payable by the seller or transferor at the time of sale. Date & Place of Signing ' (3) OWNER(S) SIGNATURE Signature of �/ C.),/, t �r 1,� Grantee/Agent A ne/ X10-J ` ..: Name (print) 1'2 hi..J-- 42 At4 A: /9- Date & Place of Signing 4/1S`/9.7 - 8 PERJURY Perjury is a class C felony which is punishable by imprisonment in a state correctional institution for a maximum term of not more than five years, or by a fine in an amount fixed by the court of not more than five thousand dollars($5,000.00), or by both imprisonment and fine (RCW 9A.20.020 (IC)). DISTRIBUTION: Original - County Treasurer 1st Copy - Department of Revenue 2nd Copy - County Assessor 3rd Copy - Taxpayer FOR TREASURER'S USE ONLY , 1 % FORM REV 84 0001A(6-93) (PD 6-10-93) '% 9 1 .1101.1.....) (_