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Home My WebLink About125236 revr Departmenntue of GS ,y REAL ESTATE EXCISE TAXAFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT when stamped by cashier. CHAPTER 82.45 RCW—CHAPTER 458-61A WAC THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY COMPLETED (See back of last page for instructions) File No.58096LS ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name 1. Name Richard R.Dickison,Personal Representative of the 2. Name Raymond DeWolf and Jenifer Lynn DeWolf, Estate of Judith L.Dickison,deceased husband and wife e4 O Mailing Address 1581 Crossbeam Dr. Mailing Address 100 Cedarview Drive z City/State/Zip Casselberry,FL 32707 City/State/Zip Port Townsend,WA 98368 in 0 Phone No.(including area code) (321)356-3739 Phone No.(including area code) (862)377-3697 3. Send all property tax correspondence to:0 Same as Buyer/Grantee List all real and personal tax parcel account Listed assessed value(s) numbers—check box if personal property Name Raymond DeWolf 965 300 038/33671 ❑ 242,483 Mailing Address 100 Cedarview Drive 0 City/State/Zip Port Townsend,WA 98368 ❑ Phone No.(including area code) (862)377-3697 0 Street address of property: 130-1 Upper Bluffs Drive Unit 3038,Port Townsend,WA 98368-9503 This Property is located in unincorporated Jefferson County OR within 0 city of Port Townsend ❑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): Eig List all personal property(tangible and intangible)included in selling 14 price. Enter any additional codes: (See back of last page for instructions) Was the seller receiving a property tax exemption or YES NO Deferral under chapters 84.36,84.37 or 84.38 RCW (nonprofit organization,senior citizen,or disabled person, Elhomeowner with limited income)? El 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? 0 El Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? ❑ ® WAC No.(Section/Subsection) Is this property receiving special valuation as historical property per chapter 84.26 RCW? ❑ ® Reason for exemption If any answers are yes,complete as instructed below. Type of Document Personal Representative's 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 13,2016 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 $ 275,000.00 If the 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 Personal Property(deduct) $ 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 $ 275,000.00 This land Excise Tax: State $ 3 520.00 ❑does ❑does not qualify for continuance Local $ 1,375.00 *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 $ 4,895.00 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 $ 4,900.00 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 IS TRUE AND CORRECT Signature of ��/ of Grantor or Grantor's Agent 'f3j .., ( ) 4 Signature or g Pis/Sone( topre5.0.1�ra. Grantee Grantee's Agent Name(print) The Estate of Judith L.Dickison,de eased Name(print) Raymond DeWolf Date&city of signing: ///l zp/6, �'�Ss��b�r-r�/ �►Z 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(IC). REV 84 0001a(04/30/09) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER 7420.35 12=+=236 *4/22/2016 4,900.00* s:#: L2Si.. co (eevenDeparlmerrtue of Wa,nmi:a I,a,4 REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT when stamped by cashier. CHAPTER 82.45 RCW—CHAPTER 458-61A WAC THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY COMPLETED (See back of last page for instructions) File No.58096LS ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name 1. Name Richard R.Dickison,Personal Representative of the Name Raymond DeWolf and Jenifer Lynn DeWolf, Estate of Judith L.Dickison,deceased husband and wife w O Mailing Address 1581 Crossbeam Dr. cG w Mailing Address 100 Cedarview Drive F wF- z w City/State/Zip Casselberry,FL 32707 City/State/Zip Port Townsend,WA 98368 CD Phone No.(including area code) (321)356-3739 Phone No.(including area code) (862)377-3697 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 Raymond DeWolf 965 300 038/33671 ❑ 242,483 Mailing Address 100 Cedarview Drive ❑ City/State/Zip Port Townsend,WA 98368 0 Phone No.(including area code) (862)377-3697 ❑ LI Street address of property: 130-1 Upper Bluffs Drive Unit 3038,Port Townsend,WA 98368-9503 This Property is located in®unincorporated Jefferson County OR within❑city of Port Townsend 0 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): ® List all personal property(tangible and intangible)included in selling 14 price. Enter any additional codes: (See back of last page for instructions) Was the seller receiving a property tax exemption or YES NO Deferral under chapters 84.36,84.37 or 84.38 RCW (nonprofit organization,senior citizen,or disabled person, homeowner with limited income)? ❑ El 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? 0 El Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? ❑ ® WAC No.(Section/Subsection) Is this property receiving special valuation as historical property per chapter 84.26 RCW? ❑ ® Reason for exemption If any answers are yes,complete as instructed below. Type of Document Personal Representative's 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 13,2016 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 $ 275,000.00 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 $ 275,000.00 Excise Tax: State $ 3,520.00 This land ID does ID does not qualify for continuance Local $ 1,375.00 *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 $ 4,895.00 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 $ 4,900.00 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 IS TRUE AND CORRECT Signature of Signature of Grantor or Grantor's Agent Grantee or Grantee's Agent Name(print) The Estate of Judith L.Dickison,deceased Name(print) Raymond DeWolf '`I Af-m / Date&city of signing: Date&city of signing Nfry 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 0001a(04/30/09) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER EXHIBIT A Unit 3038, Building 19 The Bluffs at Kala Point, a Condominium, as recorded in Volume 1 of Condominiums, pages 102 through 104, under Auditor's File No. 266603, records of Jefferson County, Washington, and amended by as-built Surveys recorded in Volume 1 of Condominiums, pages 105 through 107, inclusive, under Auditor's File No. 268712; Volume 1 of Condominiums, pages 108 and 109, under Auditor's File No. 269267; Volume 1 of Condominiums, pages 110 and 111, under Auditor's File No. 271681; Volume 1 of Condominiums, pages 112 to 114, inclusive, under Auditor's File No. 272123; Volume 1 of Condominiums, pages 115 to 117, inclusive, under Auditor's File No. 274194; Volume 1 of Condominiums, page 132, under Auditor's File No. 280399; Volume 1 of Condominiums, page 133, under Auditor's File No. 280433; Volume 1 of Condominiums, page 136, under Auditor's File No. 282846; Volume 1 of Condominiums, page 138, under Auditor's File No. 285554, Volume 1 of Condominiums , pages 139 to 140, under Auditor's File No. 288945; Volume 1 of Condominiums, page 141, under Auditor's File No. 289306; Volume 1 of Condominiums, page 144, under Auditor's File No. 291444; Volume 1 of Condominiums, page 148, under Auditor's File No. 319277; Volume 1 of Condominiums, page 155, under Auditor's File No. 328086, Volume 1 of Condominiums, pages 207 through 209, under Auditor's File No. 337706; Volume 1 of Condominiums, pages 258 and 259, under Auditor's File No. 343096; and Volume 1 of Condominiums, pages 267 and 268, under Auditor's File No. 349659; Volume 2 of Condominiums, pages 73 and 74, under Auditor's File No. 385994, Volume 2 of Condominiums, Pages 193 and 194, under Auditor's File No. 532707, and Volume 2 of Condo, pages 195 and 196, under Auditor's File No. 536105; TOGETHER WITH 2.68% percentage of undivided interest in the common areas and facilities appurtenant thereto as described in the Declaration of Condominiums under the Horizontal Property Regimes Act of the State of Washington, as recorded on the 13th day of June, 1980, under Auditor's File No. 266004, at Volume 135 of official records, pages 345 through 390, inclusive, and as amended by Amendments to Declaration for Kala Bluff, a Condominium, recorded in Volume 141 of official records, pages 302 and 303, under Auditor's File No. 268713; Volume 142 of official records, pages 451 to 457, inclusive, under Auditor's File No. 269268; Volume 148 of official records, pages 340 to 347, inclusive, under Auditor's File No. 271682; Volume 149 of official records, page 326 and 327, under Auditor's File No 272124; Volume 154 of official records, pages 211 and 212, under Auditor's File No. 274195; Volume 157 of official records, pages 597 and 598, under Auditor's File No. 275930; Volume 167 of official records, pages 570 and 571, under Auditor's File No. 280400; Volume 167 of official records, pages 618 and 619, under Auditor's File No. 280434; Volume 168 of official records, pages 590 and 591, under Auditor's File No. 280886; Volume 173 of official records on pages 122 and 123, under Auditor's File No. 282847; Volume 176 of official records, pages 56 and 57, under Auditor's File No. 284173; Volume 179 of official records, pages 257 and 258, under Auditor's File No. 285555; Volume 187 of official records, pages 582 through 589, under Auditor's File No. 288946; Volume 188 of official records, pages 515 to 516, under Auditor's File No. 289310; Volume 193 of official records, pages 644 and 645, under Auditor's File No.291443; and under Auditor's File Nos. 312361, 337707, 349658, 374232, records of Jefferson County, Washington; Said Apartment, common property being subject to restrictive covenants, rights and easements for the provisions of utilities, access and drainage as may be set forth in the Declaration of Condominiums above mentioned. Subject, however, to possible partial defeasance of this undivided interest upon inclusion of any subsequent phase or phases to the Condominium by recorded amendments to the Declaration. Situate in the County of Jefferson, State of Washington.