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Home My WebLink About123098 Department of -9V?1 n ue Wash man an Stare r k' >C REAL ESTATE EXCISE TAX AFFIDAVIT This form is your rlede p`t` ' ' PL t EASE TYPE OR PRINT when stamped by cashier. r;��}_" CHAPTER 82.45 RCW—CHAPTER 458-61 A WAC THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY COMPLETED (See back of last page for instructions) File No.80854.1MM ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name I. Name William J.Snyder and Laura M.Snyder,husband Name Daniella M.Brockmeier,a single woman and Robert and wife D.Hubert,a single man ae O Mailing Address P.O.Box 372 w Mailing Address 391 Sentinel Firs Rd. City/State/Zip Chimacum,WA 98325 City/State/Zip Port Hadlock,WA 98339 C7 Phone No.(including area code) (360)437-7791 Phone No.(including area code) 3. Send all property tax correspondence to:❑Same as Buyer/Grantee List all real and personal tax parcel account Listed assessed value(s) numbers—check box if personal property Name Daniella M.Brockmeier and Robert D.Hubert 921 193 026,921 193 027 ❑ 12,000.00;220,841.00 Mailing Address 391 Sentinel Firs Rd. "1-4. Z ❑ City/State/Zip Port Hadlock,WA 98339 ISICSF ❑ Phone No.(including area code) ❑ FI'( )/ in Street address of property: 391 Sentinel Firs Rd.,Port Hadlock,WA 98339 This Property is located in X unincorporated Jefferson County OR within❑city of Port Hadlock ❑Check box if any of the listed parcels are 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) SEE EXHIBIT"A" ATTACHED HERETO AND MADE A PART HEREOF FOR COMPLETE LEGAL DESCRIPTION ® Select Land Use Code(s): 11 NE List all personal property(tangible and intangible)included in selling price. Enter any additional codes: (See back 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 Is this property classified as current use(open space,farm and ❑ x agricultural,or timber)land per chapter 84.34? WAC No.(Section/Subsection) Is this property receiving special valuation as historical 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)below. The county assessor must then determine if the land transferred continues to qualify and will indicate by signing below. Gross Selling Price $ 282,425.00 If the land no longer qualifies or you do not wish to continue the designation *Personal Property(deduct) $ or-classification,it will be removed and the compensating or additional taxes will be due and payable by the seller or transferor at the time of sale. (RCW Exemption Claimed(deduct) $ No 84.33.140 or RCW 84.34.108). Prior to signing(3)below, you may contact your local county assessor for more information. Taxable Selling Price $ 282,425.00 This land ❑does ❑does not qualify for continuance Excise Tax: State $ 3,615.04 Local $ 1,412.13 *Delinquent Interest: State $ Local $ DEPUTY ASSESSOR DATE *Delinquent Penalty $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) Subtotal $ 5,027.17 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 $ 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 $ 5,032.17 r PRINT NAM A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX rlydPV �1 5k, cizt.J *SEE INSTRUCTIONS ,4'. ;CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT Signature of Signature of Grantor or Grantor's Agent Grantee or Grantee's Aleut j/4 .L_ �,C` %Y'�� L✓7 @ Name(print) William J.Snyder Name(print) Daniella M.Brockmeier Date&city of signing: 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($5,000.00),or by both imprisonment and fine(RCW 9A.20.020(1C). REV 84 0001 a(04/30/09) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER .14 70191 12309:3 :$:4/__i/2015 5f!I.-,2.17: l2V,D0t' 91c 15 EXHIBIT A• •Parcel A: That portion of the Southeast 1/4 of the Southwest 1/4 of Section 19, Township 29 North, Range 1 East, W.M., described as follows: Beginning at a point 327.3 feet North and 2,041.2 feet West of the Southeast corner of the Southwest 1/4 of the Southeast 1/4 of said Section 19; thence South 88° 39' 40" West 150 feet; thence North 0° 16' West 150 feet; thence North 88° 39' 40" East 150 feet; thence South 0° 16' East 150 feet to the True Point of Beginning; TOGETHER WITH the North 30 feet of Tract 48 of a Survey recorded under Auditor's File No. 240247, records of Jefferson County, Washington; ALSO TOGETHER WITH that portion of the Southeast 1/4 of the Southwest 1/4 of Section 19, Township 29 North, Range 1 East, W.M., described as follows: Beginning at a point 327.3 feet North and 2,041.2 feet West of the Southeast corner of the Southwest 1/4 of the Southeast 1/4 of said Section 19; thence South 88°39'40" West 150 feet; thence Southerly to the Northwest corner of Tract 48 of a survey recorded under Auditor's File No. 240247, Volume 2 of Surveys, page 38, records of Jefferson County, Washington; thence Easterly along the Northerly boundary of Tract 48 to the Northeast corner thereof; thence Northerly to the Point of Beginning, as awarded in Jefferson County Superior Court Case No. 13-2-00031-7; ALSO TOGETHER WITH an easement for ingress, egress and utilities as granted by instrument recorded under Auditor's File No. 200271. Situate in the County of Jefferson, State of Washington. Parcel B: That portion of the Southeast 1/4 of the Southwest 1/4 of Section 19, Township 29 North, Range 1 East, W.M., described as follows: Beginning at a point 327.3 feet North and 2,041.2 feet West of the Southeast corner of the Southwest 1/4 of the Southeast 1/4 of said Section 19; thence South 88°39'40" West 150 feet; thence North 0°16' West 338.4 feet, more or less to the Southerly margin of roadway easement described in Declaration of Easement recorded under Auditor's File No. 200271; thence South 3 04'06" East 150 feet; -:?)9° thence South 0°16' East to the Point of Beginning; TOGETHER WITH an easement for ingress, egress and utilities as granted by instrument recorded under Auditor's File No. 200271. Situate in the County of Jefferson, State of Washington. (--„ssoN---c,0� ' Jefferson County ti ,- Assessor's Office THE HEART OF THE . , OLYMPIC PENINSULA www.co.jefferson.wa.us ,-,Is III NG, G Jeff Chapman, Assessor May 15, 2015 Grantor: William J. Snyder Grantor: Laura M. Snyder Grantee: Daniella M. Brockmeier Grantee: Robert D. Hubert RE: Sale/Purchase of Parcel No. 921193026, 921193027 Excise Tax Affidavit No. 123098 Affidavit Date: April 30, 2015 While processing this property transaction an issue was found with the legal description. The bearing call of South 39°04'06" East according to existing records should actually be South 89°04'06" East. We have highlighted the error on the enclosed copy of this transaction. This office will process this transaction but advise you to correct your records. You should also re-record this transaction to keep the recorded documentation of this parcel correct. All future transactions pertaining to this parcel must have the complete, correct legal description. To correct and re-record this, please contact the title company or attorney who prepared the documents for you. Or, to correct the documents yourself, please make changes to the description on the recorded Deed. Write "This document is being re-recorded to correct the legal description hereon" on the front of the Deed; complete a new Excise Tax Affidavit and have the Treasurer's Office stamp the Deed; record the Deed at the Auditor's Office. When re-recording your transaction,please be sure to re-record the entire document and not just the portion that has the legal description error. Thank you for assisting us with maintaining the accuracy and integrity of the land records for Jefferson County. Should you have any questions regarding this matter, please contact our office at 360-385-9105. Respectfully, JEFFERSON COUNTY ASSESSOR'S OFFICE P.O.Box 1220,Port Townsend,WA 98368 - Phone(360) 385-9105 - Fax(360) 385-9197