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HomeMy WebLinkAbout123093 Di'sartswi1 nf revenue L Vol4typrc,rtge PLEASE TYPE OR PRINT REAL ESTATE -EXCISE TAX AFFIDAVIT This(ban is your receipt when by cashier. CHAPTER 82.45 RCW—CHAPTER 458-61A WAC stamped THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY COMPLETED (See back of last page for instructions) File No.8099LIMM [3 Check box if partial sale of property If multiple owners,list percentage of ownership next to name 1. Name Dorothy E.Hopkins,Trustee of the Lucille M. Name Lucy Nell Mahan and Mark Mahan as Trustees of Brown Trust,dated July 23,1990 The Nlatthew C. Mahan 2012 Irrevocable Trust dated December 20,2012 Mailing Address P.O.Box 4309 cc : Mailing Address 207 E.Northern Lights,Suite 207 z City/State/Zip Bremerton,WA 98312 ;,-2 City/State/Zip Anchorage,AK 99503 Phone No.(including area code) (360)710-1196 Q Phone No.(including area code) (360)774-2825 3. Send all property tax correspondence to:0 Same as Buyer/Grantee List all real and personal tax parcel account numbers-check box if personal property Listed assessed value(s) The Matthew C.Mahan 2012 Irrevocable Trust dated 89,390.00 Name December 20,2012 901 313 007 Mailing Address 207 E.Northern Lights,Suite 207 fl City/State/Zip Anchorage,AK 99503 22.Z 1 ) 0 Phone No.(including area code) (360)774-2825 0 Street address of property: XXX Woodstove Road,Port Townsend,WA 98368 This Property is located in X unincorporated Jefferson County OR within[3 city of Port Townsend 0 Check box if any of the listed parcels arc being segregated from a larger parcel,are part of 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) Government Lot 4 in Section 31,Township 29 North, Range 1 West, W.M., EXCEPTING therefrom Lind Road along South boundary thereof; ALSO EXCEPT a strip of land conveyed to the City of Port Townsend by instrument recorded February 21, 1929 under Auditor's File No. 60452. Situate in the County of Jefferson, State of Washington. Select Land Use Code(s): 88 RE List all personal property(tangible and intangible)included in selling price. Enter any additional codes: (See hack of last page for instructions) Is this property exempt from property tax per YES NO chapter 84.36 RCW(nonprofit organization)? X 6. YES NO Is this property designated as forest land per chapter 84.33 If claiming an exemption,list WAC number reason for exemption: RCW? X 0 Is this property classified as current use(open space,farm and Ei x agricultural,or timber)land per chapter 84.34? WAC No.(Section/Subsection) Is this property receiving special valuation as historical 0 X property per chapter 84.26 RCW? Reason for exemption If any answers are yes,complete as instructed below. Type of Document Statutory Warranty Deed (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) NEW OWNER(S): To continue the current designation as forest land or Date of Document April 27,2015 classification as current use (open space, farm and agriculture, or timber) land,you must sign on(3)helmv. The county assessor must then determine if the land transferred continues to qualify and will indicate by signing below. Gross Selling Price S 67,500.00 It'the land no longer qualities or you do not wish to continue the designation *Personal Property(deduct) S or classification,it will he removed and the compensating or additional taxes will he due and payable by the seller or transferor at the time of sale, (RCW Exemption Claimed(deduct) S No 84.33.14()or RCW 84.34.108) Prior to signing(3)below. you may contact your local county assessor for more information. Taxable Selling Price S 67,500.00 Excise Tax: State S 864.00 This land vpic :::p does not qualify for continuance Local S 337.50 , *Delinquent Interest: State S j #t&0115 Local S DEPUTY ASSESSOR DATE *Delinquent Penalty S (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) Subtotal S 1,201.50 NEW OWNER(S): To continue special valuation as historic property, sign(3)below. If the new owner(s)do not wish to continue,all *State Technology Fee S 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 S (3) OWNER(S)SIGNATURE Total Due S 1,206.50 / t or, e-f4,66 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX Lucy Nell Mahan *SEE INSTRUCTIONS 1111 I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT ture Signa of S' aturc of ign Grantor or Grantor's Agent 4 a Grante Grantee's Alen Name(print) Lucille M.Tiro 'n Name(print) - VIrsta_ Date&city of signing: jsri -,AMOME,11111Ming Date&city of signing in —12 r - 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 tine in an amount fixed by the court of not more than five thousand dollars(85,000.00),or by both imprisonment and fine(RCW 9A.20.020(1C) REV 84 0001a(04/30/09) TFITS SPACE—TREASURER'S USE ONLY COUNTY TREASURER ,H) 701012 123093 *4/30/2015 I 4206 I 2:2,0 RPR-28- 015 01:05PM From: To:13603856967 Page:19•18 lJ l her l has ri('Jowl sp1.,tr MYI'lAs I t Iiiallij,l'ON.H.YS.hM INICCtnJt,ti t.i um nyrshrp ne\1 t0 n)ti • Nainc Ihrrotht E. NtutIsini•. Trustee of ihs•t.uciltc 11. Nanx• lanes Neil 1tnlian unt5 Mork.tttihuu us'I'roueet ni I Dross n 1 Yaki.dated Juh 13. 1990 II ht,latitte ii C,Mahan 1012 I r r`oe-Ale Trust . tinted t)eeetnher 21111111 i i x x tlathng,tJsirc.. P.O.fio%43114 � 1 ,t Mutittte Address 107 E.\orllrcrn 1.hjIii .,`Vlte 21) 7 y ('nrritatrfZf )ircnterion.11'rt y ; r ; p $31« _i 3 C'lty,$tMearLip Atxttorage.AK 94503 _- t`honc lw.ttn:ladutg nse vvttCl (361)}710-11'+14- i s. Phone Ns%tsm:ludtng asca anidrl 1360)774-11it2; iii >psd all pn•pens Cis i.trrestnand enee to 0 Sante as()ut.r'C,runttt:. Lta At rcal and prsstulat tsa parrot u1twnt nurnbi:rs-ebeek 1x11.if pers.:and poverty L.1‘11.4+�sc+..d■nlust+l 'Chi'i1titibr•t C.1MUboti 2012 trrestsrahte trod dated /39.390,08 `am.: L)ceenther 10.2011 901 113007 _ 0 mnittnw Address 207 e,Northern Lights,%t►ite 2117 -_- i� . t'itytSwne?Zits Anti/wads'. +1ti'ti)5U3 —' Phone No 1110m/tog ifv.Cs•4 l 1360)774.21125 TM . .-' 0 Eir Ct"v.'1.,•Jttes Sripn.p.1r. Yt\t1 Dwelt tt r hood,t'rttt 1'ronntcnd..NA.t 4t476li t'•m.Prttyrett),.located m) unincorporated Jefferson ('uuttty on is tdun 0 cety of Port Tnxtnsend 0 C'h.x hi.,,,ti any,.i the lr.+ttt p:rtt,:l+sett t'Cti g u.Iti i.-ii it a(artier pond.tic pan oflinuadary tow rntpaasrn>,-nt•n teircelt!smog moped Legal description ui i npcny of more,parr is needed,you,+nos uitxh u 14punt •a'ttrri to each flag of the MMus C;avernment 1.014 in Section 31,Townnhip 29 North. Range I West,\V.M.. EXCI:I'1'INCi tht:reFram Lind Road along South boundary thercur; A LS() EXCEPT a strip or land conveyed to the City of Pon Townsend by instrument recorded February 21. 1929 under Auditor's Flit:No, 6045:, S itu:au in the County of 3crfelst?lt. Slate of Witishinbton 11110117-jeis--ei Land t i;e,or is, g. For Lt.t all personal prolwYt.t tangtbk and tntanptM.i Ito NO:J.1 to wiimtr __ _ tt:tct Enter any uihhtaat:ii:cii i,. _ 1 _ _. ^ 15etr baut,of tali mu:tiwirtan1c ions) Is hies property cs.•rnto item property tae pi r YIN NO 1 ttotplery4 It.Rt'1t ttuovsitit,trgam:atoml' ❑ X _. _.___.._- YLS NO j Is this lains..nty dcsign4teJ as rives'Lund per chapter 1t4 3.t : if ctautnine au eaylnpluin,.Ii#,WM•nutrtte►tra.nn Iii/etemptuin KcV.' \ ❑ 1 tt.1ni.;invert).tysattied as current use topeu.mac..DOD text a riiulittrpt,in tinilL'rl Idol pcY Chipter ltd .I4 t ❑ 't I \%A1.. No llieutwtttSubaailont !s thou prupen)trtei%mg apectol%aluatrcoi as htstsetcal prul+cnr i t7 chapter 44.16 RCt1" © Rcasna inr;met nptitm If any au.tiels Mk!.)h,r•rtiplele).i+r4rvtttt1 bet.nt j l})srat'tvcvmcnt `tntuturt 55Jirrnnh D'ctt ft NOri Ch.OF C0.11.LANCE tt'ORR.U1 LAND Olt Ct K1tL.\T t t) tiLW OWNLRIS i lo a nue die enteral desiputatun $% fareo land of I plate or Doe-omen) tprit_7.2(115 tlASCA4C,tlnta J5 eurr4DT uW l.pin spavt, cum tuo alyt 'i)tvre.of tiattrer) f,nj,lion most slr.n on(3)beton The county m:essor must then Menu= 1 it Mu Imul wnaictry,d catn+nura w tlmtliry tiuU s.iii rn litatc by miming Won I Gros:Selhutg t'rtec S, _ 67.500.00 It it Laui flu iun$ur yustitic■ur)via do run wish to Coatmts•air JtstjiturD 1 *Personal Pr-DPctry idcduct) S UT ,1,,•uit•atiun.U will to tv1 iq%p4 and Uie cvutper*i:rting or afditital t33cS i 41111 he due ontt payable by UM,titer or transtetrtr of the um:at talc dies ! Excmpiir n L i/tiiiied lttrsducl) S Vo yy 33 i.iti iii K(1t, \4)4 11001 Pnssr to.inning t7)bettor,you may rustic, i• .our heal County .CS.ur for mn.rn•odornwtron 1 Taxable Selling ['rive S 67,5410.111) thn t,,nd t!•c• ❑d,ec.}nit i uahty tiY r,alilntl.3n; 1 Vrt:ice:'rtt:• Stair 5 064,00 t t.tic,sl S ,337.5 * / i •11011/0guent inturr.i• State S �. 1%i_ _•-a!_0 3C'-i I.t�:n1 Dug.;IY 4SSL.L•St)tt. RA'R: + •lc11ngttrnl Penalty 5w!^�_�� 121 N(I1 ICI.Oh CO rLJAtiCE(111STORIC PROPtltt•t't i I Subtotal $ 1 ZO in NI t.)W.i•KO) Tti Cuttmur special satuaiit n as istonc profcnt. ■tan 13)Iretou ll itrc nun.rsnncrt►4Jm no)nisb tocotoatur.all t •Stott:Technology I'cc S 5.00 uddiuim:ii OA a It:ul:tlsd puntntnt iv(dugout$4,:fs RC'5.5tta11 br ilve mut pujaAtP I .at.sitter••Irinatjjiw At ON Brno 91 sick 'A:liilavit t')' x cin 1-cc S I 01 t)ttNFIt(`iiSil;N.t?t'Itt` Total Due 5 Y 1.206.50 P1t1NTN:AMtk i A 3ITNIMUal OF SIO.UO IS i)UE LN FEE(S)r‘..'s1.)/Olt TAX. ! 'SEE INSTRUCTIONS Lucy Nell c\)tlhan1f+S'21.11/111 t� �)� `I t...- �Z..w.a` 'I i a .rni6. sir ICFRtI n'UNDER PE\Airs orPrYU1'RV VIA T111 f'f)ItF(O.{iISTHE'f: ANDCCRKI('T 1