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Home My WebLink About123083 Department of t t_ ' t•) /l. C' Revenue 1 ''`1 �� Washington State st ,�7 t t 7 REAL ESTATE EXCISE TAX AFFIDAVIT This form is your recetpt ..\A -I PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-6I A 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. 0 Name John Mitchell Wilson fl NameJohn Mitchell Wilson ce Personal Rep for the Estate of Collete Scntta Russell w z Mailing AddressP.O.Box 343 Z Mailing.Address P.O.Box 343 E,, city/state/zipBrinnon.WA 98320 m g city/State/ZipBrinnon,WA 98320 o Phone No(including area code)(360)796-4796 Phone No.(including area code) List all real and personal property tax parcel account g Send all property tax correspondence to:0 Same as Buyer/Grantee numbers—check box if personal property List assessed value(s) Name 50229402222 n x'00 Mailing Address Pe:m il'+-• .;s tD 11 City/State/Zip I .1�g 5t • P n Phone No.(including area code) LT 1 (LS TAV 4C,) n liStreet address of property:312686 Highway 101 Brinnon,WA 98320 This property is located in Jefferson County Q ❑Check box if any of the listed parcels are being segregated from another parcel,are part ofa 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) Petersen-Smith Short Plat/Lot 1 (Less Tax 46)Subj/Ease Uotavolic( bra 12$1-12� Select Land Use Code(s): List all personal property(tangible and intangible)included in selling ((-)c.,.._ "S i�` n.� '� CI. price. enter any additional codes: NONE (See back of last page for instructions) YES NO Was the seller receiving a property tax exemption or deferral under ❑ E chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior citizen,or disabled person,homeowner with limited income)? IIIYES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33RCW? ❑ ❑ WAC No.(Section/Subsection) L[SjS--C')(4 x a Is this property classified as parent use(open space,from and ❑ ❑ agricultural,or timber)land per chapter 84.34 RCW? Reason for exemption Is this property receiving special valuation as historical property ❑ 0 per chapter 8426 RCW? If any arnswers are yes,complete as instructed below. D (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Type of Document Quit Claim ��Claim Deed d NEW OWNER(S):To continue the current designation as forest land or Date of Document L classification as current use(open space,farm and agriculture,or timber)land, you must sign on(3)below.The county assessor must then determine if the Gross Selling Price $ land transferred continues to qualify and will indicate by signing below.If the 'Personal Property(deduct) $ land no longer qualifies or you do not wish to continue the designation or classification,it will be removed and the compensating or additional taxes will Exemption Claimed(deduct) $ be due and payable by the seller or transferor at the time of sale.(RCW Taxable Selling Price $ 0.00 84.33.140 or RCW'84.34.108).Prior to signing(3)below,you may contact Excise Tax:State $ 0.00 your local county assessor for more information. 0.0050 J Local $ 0.00 This land ❑does 0 does not qualify for continuance. *Delinquent Interest:State $ Local $ DEPUTY ASSESSOR DATE *Delinquent Penalty $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) NEW OWNER(S):To continue special valuation as historic property, Subtotal $ 0.00 sign(3)below.If the new owner(s)does nott wish to continue,all *State Technology Fee $ 5.00 additional tax calculated pursuant to chapter 26 RCW,shall be due and payable by the seller transferor at a to a of sale. *Affidavit Processing Fee $ 5.00 j' ( O (S) ATURE Total Due $ 10.00 PRINT NAME A MINIMUM OF 510.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCTIONS III I CERTIFY UNDERPENALTY OF,I�E URY THAT THE FOREGOING IS TRUE AND CORRECT, 7 f ` ,/'',' F Signature of Cn Signature of kfl Grantor or Grantor's Agent r11 C Grantee or Grantee's Agent i' '; Name(print)j�k n (\\-• cJ'l(( .I5 di., Name(print) �.. . { •L ♦ 1 Date&city of signing: 1�(4(Ic 3Y)tlixt(''./�A Date&city of signing: `1((9(ic v1(('tL`(ryI1 (/L' 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 firv.:_-- - more than five thousand dollars($5,000.00),or by both imprisonment and fine(RCW 9A.20.020(I C)). ‘.\?\k 6Z 700414 ;'.):70!:-1:7 :l4/29/201% 10 003. THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER 122,DS 5901471 Exhibit A LOT 1 OF THE PETERSON-SMITH SHORT PLAT AS PER SHORT PLAT RECORDED IN VOLUME 2 OF SHORT PLATS,PAGE 91,OFFICIAL RECORDS OF JEFFERSON COUNTY,WASHINGTON. SITUATE IN THE COUNTY OF JEFFERSON,STATE OF WASHINGTON APN#502-294-022 WHICH HAS THE ADDRESS OF 312686 HIGHWAY 101,BRINNON,WASHINGTON 98320 WILSON/RUSSELL-ULLMAN LEGAL DESCRIPTION PARCEL B AFTER ADJUSTMENT THAT PORTION OF GOVERNMENT LOT 3 IN SECTION 29,TOWNSHIP 25 NORTH, RANGE 2 WEST, W.M., JEFFERSON COUNTY, WASHINGTON, DESCRIBED AS FOLLOWS: LOT 1 OF THE PETERSEN-SMITH SHORT PLAT AS RECORDED IN VOLUME 2 OF SHORT PLATS, PAGE 91, RECORDS OF JEFFERSON COUNTY, WASHINGTON. EXCEPT THAT PORTION OF LOT 1 OF SAID SHORT PLAT DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF SAID LOT 1, ALSO BEING THE SOUTHEAST CORNER OF LOT 2 OF SAID SHORT PLAT; THENCE NORTH 23° 15' 37"WEST ALONG THE WEST LINE OF SAID LOT 1, A DISTANCE OF 50.65 FEET; THENCE NORTH 66°44' 23" EAST,A DISTANCE OF 30.92 FEET; THENCE SOUTH 08° 08'43"WEST,A DISTANCE OF 59.34 FEET TO THE POINT OF BEGINNING. COON �4w oG� Jefferson County Assessor's Office THE HEART OF THE - - OLYMPIC PENINSULA www.co.jefferson.wa.us 'fsNG(C9 Jeff Chapman, Assessor May 15, 2015 Re: Deed from: John Mitchell Wilson—Estate of Collete Scotta Russell To: John Mitchell Wilson Recorded at AFN 590974 with REET AFF # 123083 We regret to inform you that we will not be able to process this transaction. Review by this office of the Deed recently filed with the Jefferson County Auditor at AFN 590974 for parcels known as APN 502294022 indicates that the Deed is deficient and should be re-recorded with additional information, information this office is providing with this letter. We explain this statement in more detail below. The primary task of the Assessor's Office according to RCW 84.40.040 is to determine the fair market value (or"FMV") of the real property located within the County and to assess at 100% of FMV. This office can only do so if it can determine the location and size of a particular parcel. To do so, it needs a complete legal description. This information and any distinct information about the structures at that parcel allow this office to establish FMV. This office has established the following guidelines for what constitutes a sufficient legal description: Category of land Minimum needed for complete legal description division Platted Lot and/or Block within the Plat and volume and book number for recorded Plat Surveyed Name for lot(for example Lot A or Lot#1) as well as the volume and book number where the survey is recorded Metes and bounds optional Neither platted nor Metes and bounds preferred surveyed, what is Any reference to a Tax number as in"Tax 111" commonly called must refer to the Auditor's File Number where Tax "acreage" 111 was created or where said Tax Number was legally modified. There may be other categories of land division that are not listed here but these three categories cover the vast majority of land in our County. Please contact the Assessor's Office or a title company for assistance in those other cases. P.O.Box 1220,Port Townsend,WA 98368 - Phone(360) 385-9105 - Fax(360) 385-9197