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Home My WebLink About125259 !�Deryirtmen�of .\ 5C) Cevenue (i5- ) REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT when stamped by cashier. CHAPTER 82.45 RCW—CHAPTER 458-6IA WAC THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY COMPLETED (See back of last page for instructions) File No. 58009LS 0 Check box if partial sale of property If multiple owners,list percentage of ownership next to name 1. Name Michael C.Glaviano and Lyn Glaviano terMeerName William C.Janss,Jr and Diana L.Davis,husband Trustees of the Michael C.Glaviano and Lyn and wife Glaviano terMeer Living Trust dated December 3, 2004 x O Mailing Address 1892 Olive St x w Mailing Address 1200 Cincinnati Ave aH >- z City/State/Zip Eugene,OR 97401 City/State/Zip El Paso,TX 79902 Phone No.(including area code) (360)531-2857 0 Phone No.(including area code) (915)449-8127 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 William C.Janss,Jr 984 905 102/38155 0 641,288 Mailing Address 1200 Cincinnati Ave ❑ City/State/Zip El Paso,TX 79902 ❑ Phone No.(including area code) (915)449-8127 0 131 Street address of property: 1820 Maple St,Port Townsend,WA 98368-3807 This Property is located in 0 unincorporated Jefferson County OR within El 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 11 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)? ❑ 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 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 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 March 31,2016 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 $ 738,000.00 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 $ 738,000.00 Excise Tax: State $ This land ❑does 0 does not qualify for continuance 9,446.40 Local $ 3,690.00 *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 $ 13,136.40 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 $ 13,141.40 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 ��//JJ � /� Signature of Grantor or Grantor's Agenf/��1 �i2a' Grantee or Grantee's Agent Michael C.Glaviano and Lyn Glaviano terMeer Name(print) Living Trust dated December 3,2004 Name(print) William C.Janss,Jr Date&city of signing: </-/-,2.2.0/40 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 0001a(04/30/09) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER • . 74.7459 125259 rti/26,'2C.3 16 I 5 141 2,c2,g1 IIIi 4 i)176111 ef Vtintres.State REAL ESTATE EXCISE TAX AFFIDAVIT This fonts 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.58009LS 0 Check box if partial sale of property If multiple owners.list percentage of ownership next to name Name Michael C.Glaviano and Lvn Glaviano terMeer, Name William C.Janss,Jr and Diana L.Davis,husband Trustees of the Michael C.Glaviano and Lyn and wife Glaviano terMeer Living Trust dated December 3, 2004 tl.) c4 0 Mailing Address 1892 Olive St c4 L14 Mailing Address 1200 Cincinnati Ave w —1 z d < City/State/Zip Eugene,OR 97401 c4:-- City/State/Zip El Paso,TX 79902 vt :0 Phone No.(including area code) (360)531-2857 (.7 Phone No.(including area code) (915)449-8127 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 William C.Janss,Jr 984 905 102/38155 0 641.288 Mailing Address 1200 Cincinnati Ave 0 City/State/Zip El Paso,TX 79902 0 Phone No.(including area code (915)449-8127 0 gm Street address of property: 1820 Maple St,Port Townsend,WA 98368-3807 This Property is located in 0 unincorporated Jefferson County OR within[E]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 shed to each page of the affidavit) SEE EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF FOR COMPLETE LEGAL DESCRIPTION Es Select Land Use Code(s): ME List all personal property(tangible and intangible)included its selling 11 price. Enter any additional codes: (See back of last page for instruction.$) 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. El El homeowner with limited income)? 6. YES NO Is this property designated as forest land per chapter 84.33 If claiming an exemption,list WAC number reason for exemption: RCA"? 0 Is this property classified as current use(open space,farm and 0 /21 agricultural,or timber)land per chapter 84.34? WAC No.(Section/Subsection) Is this property receiving special valuation as historical 0 property per chapter 84.26 RCW? Reason for exemption If any answers are yes,complete as instructed below. Type of Document Statutory Warranty Deed (I)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) NEW OWNER(S): To continue the current designation as forest land or Date of Document March 31,2016 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 $ 738,000.00 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 $ 738,000.00 Excise Tax: State $ 9,446.40 This land 0 does 0 does not quality for continuance Local $ 3,690.00 *Delinquent Interest: State $ Local $ DETC117 ASSESSOR DATE *Delinquent Penalty S (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) NEW OWNER(S): To continue special valuation as historic property, Subtotal $ 13,136.40 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 he due and payable by the seller or transferor at the time of sale. *Affidavit Processing Fee $ (3) OWNER(S)SIGNATURE Total Due $ 13,141.40 PRINT NAME A MINIMUM OF S10.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCTIONS 11 I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE 'NO CORRECT Signature of Signature of Grantor or Grantor's Agent Grantee or Grantee's A ent X ( Michael C.Glaviano and Lyn Glaviano terMeer Name(print) Living Trust dated December 3,2004 Name(print) William C.Janss,Jr .. Date&city of signing: Date&city of signing impieggimmungrAgimpr Perjury: Penury is a class C felony which is punishable by imprisonment in the state correctional institution fo a maxim1um term of not snore than five years,or by a fine in an amount fixed by the court of not more than five thousand dollars(S5,000,00),or by both imprisonment and tine(RCW 9A.20.020(1C). REV 84 0001a(04/30/09) THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER EXHIBIT A Lot 2, 4, 6 and 8, Block 51, Pettygrove's First Addition to the City of Port Townsend, according to the Plat thereof filed in Volume 1 of Plats at Page 36, records of Jefferson County, Washington; TOGETHER WITH that portion of vacated Maple Street vacated under Ordinance No. 1826 of the City of Port Townsend, that would attach by operation of law. Situate in the County of Jefferson, State of Washington.