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Home My WebLink About125278 4 r pi\ ST-606 Department of ,3;-� cr Revenue REAL ESTATE EXCISE TAX AFFIDAVIT t .G1 \ , 'O 1 Washington State CHAPTER 82.45 RCW-CHAPTER 458-61A WAC This form is your receipt PLEASE TYPE OR PRINT 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. 1 C. Donald, also shown of record as Donald Albin 2 and Bonnie Jean Albin, Trustees of the Albin Leland C. Brumley and Joan Doherty Brumley, Name Family Trustf � dated August 5, 2004 Name Name husband and wife MailingAddress q 1'(i t—,V\t) [fid 'V Y V w,:e) ✓ 7Q p/� K w Mailing Address PO Box 11501 City/State/Zip �J\� �(�t�/�l22i I �/ D�1 co•i City/State/Zip Bainbridge Island, WA 98110) Phone No.(including area code)(3tk1 j 2'LiPhone No.(including area code) C��'L'��O 3 Send all property tax correspondence to: List all real and personal property tax parcel P P Y p I�Same as Buyer/Grantee account numbers-check box if personal property List assessed value(s) Name 990 200 048 ❑ $262,315.00 Mailing Address Levy Code: 39801 ❑ City/State/Zip ❑ Phone No.(including area code) ❑ 4 Street address of property: 211 N Bay Lane Unit 6, Port Ludlow, WA 98365 The property is located in❑unincorporated County OR within 2 city of Port Ludlow ❑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) Full legal description hereto attached as Exhibit"A" 5 Select Land Use Code(s): 7 List all personal property(tangible and intangible)included in selling price. Enter any additional codes: (See back of last page for instructions) YES NO Was the seller receiving a property tax exemption or deferral under ❑ 0 chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior citizen,or disabled person,homeowner with limited income)? 6 I YES NO Is this property designated as forest land per chapter 84.33 RCW? ❑ [JI If claiming an exemption,list WAC number and reason for exemption: Is this property classified as current use (open space, farm and izi ❑ agricultural,or timber)land per chapter 84.34 RCW? 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. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) NEW OWNER(S): To continue the current designation as forest land or Type of Document Statutory Warranty Deed 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 Date of Document 04/26/2016 transferred continues to qualify and will indicate by signing below. If the land no longer qualifies or you do not wish to continue the designation or classification,it will Gross Selling Price $ 336,000.00 be removed and the compensating or additional taxes will be due and payable by the *Personal Property(deduct) $ 0.00 seller or transferor at the time of sale. (RCW 84.33.140 or RCW 84.34.108). Prior to signing (3) below, you may contact your local county assessor for more Exemption Claimed(deduct) $ 0.00 information. Taxable Selling Price $ 336,000.00 Excise Tax: State $ 4,300.80 This land El does❑does not qualify for continuance. Local $ 1,680.00 *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 additional tax calculated Subtotal $ 5,980.80 pursuant to Chapter 84.26 RCW,shall be due and payable by the seller or transferor `State Technology Fee $ 5.00 at the time of sale. (3)OWNER(S)SIGNATURE *Affidavit Processing Fee $ 0.00 Total Due $ 5,985.80 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCTIONS 8 I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Signature of /�� Grantor or Grantor' Grantee or Grantee's Agen /� i Name(print) C. Doi . Albin Name(print) Leland lrumley Date&city of signingU 4 CDS.`.W �y�,-'lCiab_- Date&city of signing L4 °Lel "9 Lo 1 Vl t a. 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(6/26/14) THIS SPACE-TREASURER'S USE ONLY 0 County Treasurer ❑County Assessor Escrow No.: 611126155-EG 0 Dept.of Revenue ❑Taxpayer f 'I 749214 1'- :+:,:: - is=. 5 �{-ij:: , _ - - 1252 t Apartment No.806,of Port Ludlow Condominiums No,2,according to Survey and Set of Plans thereof filed under Auditor's File No.220304,recorded in Volume 1 of Condominiums Plans,at pages 23 to 30,records of Jefferson County,Washington; TOGETHER WITH.0460%of undivided interest in the common and limited common areas and facilities appurtenant thereto as described in the Declaration of Condominium under the Horizontal Property Regimes Act of the State of Washington,as recorded on the 15th day of October, 1973,under Auditor's File No.220303,at Volume 45 of Official Records,on pages 544 to 549,Jefferson County, Washington,as amended by instrument dated June 24, 1974,and recorded June 24, 1974,under Auditor's File No.223748,Volume 52,pages 74 to 76,inclusive; The description of the land as provided in R.C.W.64.342.090 is as follows: Beginning at the section corner common to Sections 8,9, 16 and 17,Township 28 North,Range 1 East,W.M.,Jefferson County,Washington; Thence South 00° 55' 12"West 907.02 feet along the section line between Sections 16 and 17 to a point on Port Ludlow Drive; Thence South 68° 43' 16"West 383.77 feet to the True Point of Beginning; Thence continuing South 68°43' 16"West 260.83 feet; Thence South 58° 27' 16"West 264.36 feet; Thence South 35°33' 53"East 320 feet,more or less,to the line of mean high tide; Thence Northeasterly along the line of mean high tide to a point that bears South 23°26' 44"East 316 feet,more or less,from the Point of Beginning; thence North 23°26' 44"West 316 feet,more or less,to the Point of Beginning,this line also being the Westerly line of the amended survey plan of Port Ludlow Condominiums,No. 1; EXCEPT County Road. Situate in the County of Jefferson, State of Washington.