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HomeMy WebLinkAbout123087 -.. Department of Revenue �:� 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. flName Northwest Trustee Services,Inc. © Name Federal National Mortgage Association("FNMA") Ya r�uh Choy yeeLLLL Kan W c4 c a z Mailing Address PO Box 997 ,:e z Mailing Address PO Box 650043 gCity/State/Zip Bellevue,WA 980 9-0997 m City/State/Zip Dallas,TX 75265 Phone No.(including area code) l5 -' Phone No.(including area code)(800)732-6643 © Send all property tax correspondence to: Same as Buyer/Grantee List all real and personal property tax parcel account numbers—check box if personal property List assessed value(s) Name 952 900 018 0 $285,167 Mailing Address I--I City/State/Zip 211 LH Lt n Phone No.(including area code) I--I © Street address of property: 142 George Leslie Drive,Port Ludlow,WA,98365 (JEFFERSON County) This property is located in Port Ludlow ED 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) Lot 18,Garten Estates,as per plat recorded in Volume 7 of plats,pages 171 to 175,records of Jefferson County,Washington, Situate in the County of Jefferson,State of Washington. ® Select Land Use Code(s): II List all personal property(tangible and intangible)included in selling J11-Household,single family units J price. enter any additional codes: None (See back of last page for instructions) YES NO Is this property exempt from property tax per chapter ❑ F4 84.36 RCW(nonprofit organization)? UYES NO If claiming an exemption, list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? ❑ p Is this property classified as current use(open space,farm and ❑ FA WAC No. (Section/Subsection) 458-61A-208(4) agricultural,or timber)land per chapter 84.34? Reason for exemption Is this property receiving special valuation as historical property ❑ 'A Foreclosure-Deed of Trust#530647 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 Trustee's Deed NEW OWNER(S):To continue the current designation as forest land or classification as current use(open space,farm and agriculture,or timber)land, Date of Document 4/27/15 you must sign on(3)below.The county assessor must then determine if the land transferred continues to qualify and will indicate by signing below.If the Gross Selling Price $ 235,000.00 land no longer qualifies or you do not wish to continue the designation or *Personal Property (deduct) $ 0.00 classification,it will be removed and the compensating or additional taxes will 235,000.00 be due and payable by the seller or transferor at the time of sale.(RCW Exemption Claimed(deduct) $ 84.33.140 or RCW 84.34.108).Prior to signing(3)below,you may contact Taxable Selling Price $ 0.00 your local county assessor for more information. Excise Tax : State $ 0.00 This land ED does ❑does not qualify for continuance. I 0.0000 I Local $ 0.00 *Delinquent Interest: State $ 0.00 DEPUTY ASSESSOR DATE Local $ 0.00 (2) NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Penalty $ 0.00 NEW OWNER(S):To continue special valuation as historic property, sign(3)below.If the new owner(s)does not wish to continue,all Subtotal $ 0.00 additional tax calculated pursuant to chapter 84.26 RCW,shall be due and payable by the seller or transferor at the time of sale. *State Technology Fee $ 5.00 (3) OWNER(S)SIGNATURE *Affidavit Processing Fee $ 5.00 Total Due $ 10.00 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCT'S ® I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND Aiiiii ■ Signature of . Signature of 4e .._Grantor or Grantor's Agent ., s.-�_,, :�,� / • Grantee or Grantee's Agent Name(print) Northwest Trustee Services,Inc. Emma Greenwood Name(print) Northwest Trustee Services,Inc.Christopher Frohrinq Date&city of signing: 04/27/2015.Bellevue.WA Date&city of signing: 04/27/2015,Bellevue,WA 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)). REV 84 0001ae(9/2/11) THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER ■ 700427 123'_t-i7 3:4/29?,201=, 10.00:3 1 Z--.770(2) -1