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HomeMy WebLinkAbout125284 ii Department of (it? ',../ _-,t? Revenue Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61A WAC 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) 0 Check box if partial sale of property If multiple owners,list percentage of ownership next to name. 1111 Name Edward D. Porter and Virginia M. Porter,trustees of 1111 Name Craig K.Taylor,a married man as his - L.1 H the Porter Family Trust and Sandra L.Taylor MiS ahf-� W separate estate a z Mailing Address 981 Thorndyke Road w z Mailing Address 1060 W.Hendrickson Road in City/State/Zip Port Ludlow, WA 98365 go City/state/zip Sequim,WA 98382 Phone No.(including area code) (360)437-9142 Phone No.(including area code)(360)460-8629 List all real and personal property tax parcel account ® Send all property tax correspondence to:0 Same as Buyer/Grantee numbers-check box if personal property List assessed value(s) Name Craig K.Taylor.a married man as his separate estate 710300007 {� 1(g(00\ (l 5125.00 Mailing Address 1060 W.Hendrickson Road (J n City/State/Zip Sequim,WA 98382 Tai< 12 F -1 0-1 Ee2 7 to n Phone No.(including area code)(360)460-8629 n pi a--p v- 111® Street address of property: S30 T27 R1 OW TAX RF-7(HES 274) This property is located in Jefferson CountyEl ❑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) SEE ATTACHED ® Select Land Use Code(s): III List all personal property(tangible and intangible)included in selling Jz6-Packs Q 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 9 chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior _ citizen,or disabled person,homeowner with limited income)? © If claiming an exemption,list WAC number and reason for exemption: YES NO 1 (16)Is this property designated as forest land per chapter 84.33 RCW? ❑ 0 WAC No. (Section/Subsection)(`L/5q,-LQ�,w-d0 t ( i) Is this property classified as current use(open space,fame and 0 0 Reason for exemption G1}°/C-- agricultural,or timber)land per chapter 84.34? Is this property receiving special valuation as historical property 0 0 per chapter 84.26 RCW? If any answers are yes,complete as instructed below. Type of Document ( Q. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) �� lac\ i NEW OWNER(S):To continue the current designation as forest land or Date of Document classification as current use(open space,farm and agriculture,or timber)land, Gross Selling Price $ 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.If the *Personal Property(deduct) $ land no longer qualifies or you do not wish to continue the designation or Exemption Claimed(deduct) $ 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 Taxable Selling Price $ 0.00 84.33.140 or RCW 84.34.108).Prior to signing(3)below,you may contact Excise Tax : State $ 0.00 your local county assessor for more information. 0.0050 _l Local $ 0.00 L ...{ This land aloes 0 does not qualify for continuance. *Delinquent Interest: State $ Local $ DEPUTY ASSESSOR DATE *Delinquent Penalty $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) 0.00 NEW OWNER(S):To continue special valuation as historic property, Subtotal $ sign(3)below.If the new owner(s)does 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 $ 10.00 A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX PRINT NAME *SEE INSTRUCTIONS ® I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Signature of �,/ Signature of d - Grantor or Grantor's Agent v """''��'`° Grantee or Grantee's Agent AW • ` Name(print) Edward D.Porter and ' inia M.Porter Name(print) Craig K.Taylor / t Date&city of signing: q r�qr\l 4 O "'� Date&city of signing: //. 2r l "/L6) PO r--1- -rOv-'o S '�'` 4 j 'WA. 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(01/04/16) THIS SPACE-TREASURER'S USE ONLY DEPT.OF REVEI UF.t State of Washington Department of Revenue REAL ESTATE EXCISE TAX C Miscellaneous Tax Section Olympia WA SUPPLEMENTAL STATEMENT Qlympia WA 98504-7477 (11-AC 458-61:1-304) This form must be submitted with the Real Estate Excise Tax Affidavit(FORM REV 84 0001A for deeded transfers and Form R[V 84 0001B for controlling interest transfers)for claims of tax exemption as provided below.Completion of this form is required for the types of real property transfers listed in numbers 1-3 below.Only the first page of this form needs original signatures. AUDIT:Information you provide on this form is subject to audit by the Department of Revenue. In the event of an audit,it is the taxpayers' responsibility to provide documentation to support the selling price or any exemption claimed. This documentation must be maintained for a minimum of four years from date of sale.(RCW 82.45.100)Failure to provide supporting documentation when requested may result in the assessment of tax,penalties,and interest. Any filing that is determined to be fraudulent will carry a 50%evasion penalty in addition to any other accrued penalties or interest when the tax is assessed. PERJURY:Perjury is a class C felony which is punishable by imprisonment in a 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 ($5,000.00),or by both imprisonment and fine(RCW 9A,20.020(IC)). The persons signing below do hereby declare under penalty of perjury that the following is true(check appropriate statement): 1. ❑DATE OF SALE: (WAC 458-61A-306(2)) I,(print name) certify that the (type of instrument),dated ,was delivered to me in escrow by (seller's name).NOTE:Agent named here must sign below and indicate name of firm.The payment of the tax is considered current if it is not more than 90 days beyond the date shown on the instrument.If it is past 90 days,interest and penalties apply to the date of the instrument. Reasons held in escrow Signature Firm Name 2. GIFTS:(WAC 458-61A-201)The gift of equity is non-taxable;however,any consideration received is not a gift and is taxable.The value exchanged or paid for equity plus the amount of debt equals the taxable amount.One of the boxes below must be checked. Both Grantor(seller)and Grantee(buyer)must sign below. Grantor(seller)gifts equity valued at$ to grantee(buyer). NOTE: Examples of different transfer types are provided on the back.This is to assist you with correctly completing this form and paying your tax. "Consideration"means money or anything of value,either tangible(boats,motor homes,etc)or intangible,paid or delivered,or contracted to be paid or delivered,including performance of services,in return for the transfer of real property.The term includes the amount of any lien,mortgage,contract indebtedness,or other encumbrance,given to secure the purchase price,or any part thereof,or remaining unpaid on the property at the time of sale. "Consideration" includes the assumption of an underlying debt on the property by the buyer at the time of transfer. A. Gifts with consideration 1.❑ Grantor(seller)has made and will continue to make all payments after this transfer on the total debt of $ and has received from the grantee(buyer)$ (include in this figure the value of any items received in exchange for property).Any consideration received by grantor is taxable. 2.❑ Grantee(buyer)will make payments on %of total debt of$ for which grantor(seller) is liable and pay grantor(seller)$ (include in this figure the value of any items received in exchange for property).Any consideration received by grantor is taxable. B. Gifts without consideration Lis There is no debt on the property;Grantor(seller)has not received any consideration towards equity. No tax is due. 2.E Grantor(seller)has made and will continue to make 100%of the payments on the total debt of$ and has not received any consideration towards equity.No tax is due. 3.❑ Grantee(buyer)has made and will continue to make 100%of the payments on total debt of$ and has not paid grantor(seller)any consideration towards equity.No tax is due. 4.❑ Grantor(seller)and grantee(buyer)have made and will continue to make payments from joint account on total debt before and after the transfer.Grantee(buyer)has not paid grantor(seller)any consideration towards equity. No tax is due. Has there been or will there be a refinance of the debt? ❑ YES ❑ NO(If yes,please call(360)534-1503 to see if this transfer is taxable).If grantor(seller)was on title as co-signor only,please see WAC 458-61A-215 for exemption requirements. The undersigned acknowledge this transaction may be subject to audit and have read the above information regarding record-keeping requirements and evasion penalties. -- . ..- iii � i-2 /w ..'7 -z //— 2 `,-/4) G�cantor's ignatur .7_ 1 Date Grantee's Signature Date ` , .,r-tea .,)1 'v" (�i g /Q 1/' GXa_utor's,Nan�e(rlp) y� Grantee'Same(print) VS ra L�aE 3. ❑ IRS"TAX DEFERR EXCHANGE(tb AC 458-61A-213) I,(print name) ,certify that I am acting as an Exchange Facilitator in transferring real property to pursuant to IRC Section 1031,and in accordance with WAC 458-61 A-213. NOTE: Exchange Facilitator must sign below. Exchange Facilitator's Signature For tax assistance,contact your local County Treasurer/Recorder or visit http://dor.wa.gov or call(360)534-1503. To inquire about the availability of this document in an alternate format,please call 1-800-647-7706.Teletype(TTY)users may use the Washington Relay Service by calling 711. REV 84 0002ea(6/26/14) DEPARTMENT OF REVENUE 4 A PARCEL OF LAND WITHIN H. E.SURVEY NO.274 AND WITHIN THE SOUTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SECTION 30,TOWNSHIP 27 NORTH, RANGE 10 WEST,W.M., DESCRIBED AS FOLLOWS: BEGINNING AT CORNER NO. 1 OF H.E.S. NO. 274 WHICH IS THE SOUTHEAST CORNER OF SAID SECTIN 30, THENCE NORTH 00 08' EAST ALONG THE EAST LINE OF SAID SECTION 30 FOR 722.01 FEET;THENCE NORTH 89 52'WEST A DISTANCE OF 30 FEET TO THE TRUE POINT OF BEGINNING;THENCE SOUTH 60 43'30"WEST A DISTANCE OF 200 FEET;THENCE NORTH 00 08' EAST A DISTANCE OF 377.99 FEET; THENCE NORTH 4415' EAST A DISTANCE OF 157.334 FEET;THENCE NORTH 54 45' EAST A DISTANCE OF 79.37 FEET;THENCE SOUTH 00 08'WEST A DISTANCE OF 438.696 FEET TO THE TRUE POINT OF BEGINNING,SITUATE IN JEFFERSON COUNTY,WASHINGTON.