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HomeMy WebLinkAbout123073 L L) L5 6 e) Department of i Revenue g s q i (e, Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW-CHAPTER 458-61A WAC when stamped by cashier. THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED (See back of last page for instructions) ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name. e Name Jerry Shull,as Trustee of the Jerry Shull Trust,u/a dated July 5,1989 Name Gerald Thuotte and Peggy Thuotte,husband and wife cc c: E.6 F Mailing Address PO Box 415 w Fc`,' Mailing Address 203 Seaway PI. :- c- City/State/Zip Carmel Valley,CA 93924-0415 < City/State/Zip Port Ludlow,WA 98365 • c. Phone No.(including area code) (831)659-2531 C.- Phone No.(including area code) (360)437-0863 111 List all real and personal property tax parcel account Send all property tax correspondence to:❑Same as Buyer/Grantee numbers-check box if personal property List assessed value(s) Name Gerald Thuotte&Peggy Thuotte 956300104 ❑ $31,550.00 Mailing Address 203 Seaway PI. ❑ City/State/Zip Port Ludlow,WA 98365 2, i I I ❑ Phone No.(including area code) (360)437-0863 ❑ ©Street address of property: Hangar A-4,Jefferson County Airport,Port Townsend,WA 98368 This property is located in®unincorporated Jefferson County OR within❑city of Port Townsend ❑Check box if any of the listed parcels are being segregated from another parcel,are part of a boundary line adjustment or parcels being merged. Legal description of property(if more space is needed,you may attach a separate sheet to each page of the affidavit) FULLY DESCRIBED IN EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF. ® Select Land Use Code(s): 0 List all personal property(tangible and intangible)included in selling 14 price. enter any additional codes: (See back of last page for instructions) YES NO Is this property exempt from property tax per chapter ❑ El 84.36 RCW(nonprofit organization)? © YES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? ❑ ® WAC No.(Section/Subsection) Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? ❑ ® Reason for exemption Is this property receiving special valuation as historical ❑ EI property per chapter 84.26 RCW? If any answers are yes,complete as instructed below. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Type of Document Statutory Warranty Deed NEW OWNER(S): To continue the current designation as forest land or classification as current use(open space, farm and agriculture,or timber) Date of Document April 23,2015 land, you must sign on (3) below. The county assessor must then determine if the land transferred continues to qualify and will indicate by Gross Selling Price $ 35,000.00 signing below. If the land no longer qualifies or you do not wish to *personal Property(deduct) $ continue the designation or classification, it will be removed and the compensating or additional taxes will be due and payable by the seller or Exemption Claimed(deduct) $ No transferor at the time of sale. (RCW 84.33.140 or RCW 84.34.108). Prior Taxable Selling Price $ 35,000.00 to signing(3)below,you may contact your local county assessor for more Excise Tax: State $ 448.00 information. This land ❑does ❑does not qualify tor continuance. Local $ 175.00 *Delinquent Interest: State $ DEPUTY ASSESSOR DATE Local $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Penalty $ NEW OWNER(S): To continue special valuation as historic property, Subtotal $ 623.00 sign (3) below. If the new owner(s) does not wish to continue, all *State Technology Fee $ 5:00 additional tax calculated pursuant to chapter 84.26 RCW,shall be due and payable by the seller or transferor at the time of sale. *Affidavit Processing Fee $ (3) OWNER(S)SIGNATURE Total Due $ 628.00 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TA) *SEE INSTRUCTIONS ® I CERTIFY UNDER PENALTY I F PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Signature of �-- Signature of Grantor or Grantor's Agent '.fi�j —fit _./ 'TiM /III O'Grantee or Grantee's Agent Jerry ull,as Trustee of the Jerry Name(print) Shull Trust,u/a dated July 5,1989 Name(print) Gerald Thuotte Data&city of signing:9 94 da' ettlimPleitieb ,A, Date&city of signing: Perjury: Perjury is a class C felony which is punishable by imprisonment in the 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(1C)). ° +�l�_t3_i 123073 *4/28/2015 628.00* I Hi6 SPACE—TREASURER'S USE ONLY COUNTY TREASURER 12 : al Department of Revenue 1 Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61A WAC when stamped by cashier. THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED (See back of last page for instructions) ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name. e Name Jerry Shull,as Trustee of the Jerry Shull Trust,u/a dated July 5,1989 Name Gerald Thuotte and Peggy Thuotte,husband and wife u. c�i1 EC Mailing Address PO Box 415 H Mailing Address 203 Seaway PI. w a City/State/Zip Carmel Valley,CA 93924-0415 City/State/Zip Port Ludlow,WA 98365 L Phone No.(including area code) (831)659-2531 c Phone No.(including area code) (360)437-0863 111 Send all property tax correspondence to:❑Same as Buyer/Grantee List all real and personal property tax parcel account List assessed value(s) numbers—check box if personal property Name Gerald Thuotte&Peggy Thuotte 956300104 ❑ $31,550.00 Mailing Address 203 Seaway PI. ❑ City/State/Zip Port Ludlow,WA 98365 2-C 1 ) ❑ Phone No.(including area code) (360)437-0863 ❑ ©Street address of property: Hangar A-4,Jefferson County Airport,Port Townsend,WA 98368 This property is located in®unincorporated Jefferson County OR within❑city of Port Townsend ❑Check box if any of the listed parcels are being segregated from another parcel,are part of a boundary line adjustment or parcels being merged. Legal description of property(if more space is needed,you may atach a separate sheet to each page of the affidavit) FULLY DESCRIBED IN EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF. ® Select Land Use Code(s): Q List all personal property(tangible and intangible)included in selling 14 price. enter any additional codes: (See back of last page for instructions) YES NO Is this property exempt from property tax per chapter ❑ 84.36 RCW(nonprofit organization)? ® YES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? ❑ ® WAC No.(Section/Subsection) Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? Reason for exemption Is this property receiving special valuation as historical ❑ property per chapter 84.26 RCW? If any answers are yes,complete as instructed below. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Type of Document Statutory Warranty Deed NEW OWNER(S): To continue the current designation as forest land or classification as current use(open space,farm and agriculture,or timber) Date of Document April 23,2015 land, you must sign on (3) below. The county assessor must then determine if the land transferred continues to qualify and will indicate by Gross Selling Price $ 35,000.00 signing below. If the land no longer qualifies or you do not wish to *Personal Property(deduct) $ continue the designation or classification, it will be removed and the compensating or additional taxes will be due and payable by the seller or Exemption Claimed(deduct) $ No transferor at the time of sale. (RCW 84.33.140 or RCW 84.34.108).Prior Taxable Selling Price $ 35,000.00 to signing(3)below,you may contact your local county assessor for more Excise Tax: State $ 448.00 information. This land ❑does ❑does not qualify fir continuance. Local $ 175.00 *Delinquent Interest: State $ DEPUTY ASSESSOR DATE Local $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Penalty $ NEW OWNER(S): To continue special valuation as historic property, Subtotal $ 623.00 sign (3) below. If the new owner(s) does not wish to continue, all *State Technology Fee $ 5.00 additional tax calculated pursuant to chapter 84.26 RCW,shall be due gy and payable by the seller or transferor at the time of sale. *Affidavit Processing Fee $ (3) OWNER(S)SIGNATURE Total Due $ 628.00 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCTIONS I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING ISTRUE AND CORRE Grantor of Grantee or �� Grantor or Grantor's Agent Grantee or Grantee's Agen _ ___,' ',�//� Jerry Shull,as Trustee of the Jerry Name(print) Shull Trust,u/a dated July 5,1989 Name(print) Gerald Thuotte Date&city of signing: Date&city of signing: 1i'117'15 et Perjury: Perjury is a class C felony which is punishable by imprisonmert in the 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)). REV 84 0001a(2/28/13) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER r 1 EXHIBIT "A" Lease and the Terms and Conditions Thereof. Lessor: Port of Port Townsend,a municipal corporation Lessee: . Victor Gray and Paula E.Gray,husband and wife Term: 40 years Recorded: December 4, 1995 Recording No.: 386808 Lessee interest under said lease as to the following Unit assigned to Jerry Shull,as Trustee of the Jerry Shull Trust,u/a dated July 5, 1989 by instrument dated October 30.2001 and recorded October 30, 2001 under Auditor's File No.449075. Assignment of Lease and the terms and conditions thereof: Lessee's interest assigned to:'A'Hangar Condominium Association at J.C.I.A. • By assignment recorded: April 10,2002 Recording No.: 454592 Unit A4, 'A' Hangar Condominium at J.C.I.A.,a Condominium recorded in Volume No.2 of Condominiums,pages 75 through 78,according to the declaration thereof,recorded under Jefferson County Recording Number 388401 and any amendments thereto. Situate in the County of Jefferson,State of Washington.