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Home My WebLink About125285 Departmerrt -7 3_:t C, revenueof s--G State 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.82080JMM ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name I. Name Elmer C.Hughes and Betty A.Hughes Revocable Name Diane L.Porter and Michael A.Porter,wife and Living Trust,dated February 5,1997,a Washington husband Corporation w O Mailing Address 1301 S.3rd Ave,#15B 24 w Mailing Address 6505 146th St SW wz City/State/Zip Sequim,WA 98382 m City/State/Zip Edmonds,WA 98026 t7 Phone No.(including area code) (425)418-1486 Phone No.(including area code) (000)000-0000 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 Diane L.Porter and Michael A.Porter 802 244 003/19994 ❑ 203,463.00 Mailing Address 6505 146th St SW ❑ City/State/Zip Edmonds,WA 98026 TJt I`I ( ' Moo') 0 Phone No.(including area code) (000)000-0000 0 m 6� f) v= ® Street address of property: 288944 Hwy 101,Quilcene,WA 98376 "�" This Property is located iii'unincorporated Jefferson County OR within 0 city of Quilcene 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): 11 7. List all personal property(tangible and intangible)included in selling 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, homeowners with limited income)? ❑ x ® 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 x Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? x WAC No.(Section/Subsection) Is this property receiving special valuation as historical property per chapter 84.26 RCW? x 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 26,2016 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 $ 150,000.00 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 $ 150,000.00 Excise Tax: State $ This land 0 does 0 does not qualify for continuance 1,920.00 Local $ 750.00 *Delinquent Interest: State $ Local $ DEPUTY ASSESSOR DATE *Delinquent Penalty $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) Subtotal $ 2,670.00 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 $ 2,675.00 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 1 Signature of tiowe _ Grantor or Grantor's Agent Grantee or Grantee's Agent ►�a' -� Elmer C.Hughes an'petty A.Hughe. Name(print) Revocable Living Trust,dated February ,1997 Name(print) Diane L.Porter Date&city of signing: 11/19//(0 .fes\ Date&city of signing /0y/1 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 That portion of Government Lot 4 and of the Southwest Quarter of the Southeast Quarter of Section 24, Township 28 North, Range 2 W.W.M., in Jefferson County, Washington, described as follows: Beginning at a point on the South boundary of said Section at the intersection thereof with the Easterly boundary of the right of way of the railroad formerly crossing said section,which point is 116 feet East of the meander corner common to Sections 24 and 25, said township and range; thence North 50° East along the Southeasterly boundary of said railroad right of way 165 feet; thence East 46.5 feet to the Southeasterly margin of the County road; thence North 50° East along said Southeasterly road margin 881.8 feet; thence North 40° West at rights angles to said railroad margin to the center line of said county road; thence North 50° East along said center line 200 feet; thence continuing North 50° East along said center line to intersect the Southwesterly boundary of the Olympic Highway(Primary State Highway No. 9); thence Northwesterly along said Southwesterly boundary 260 feet to the TRUE POINT OF BEGINNING; thence continuing Northwesterly along said Southwesterly boundary of the Olympic Highway, 100 feet; thence turn an angle of 95° 56' to the left in the Northwesterly quadrant from said Southwesterly boundary to a straight line; thence Southwesterly along said straight line to the shore line of Lake Leland; thence Southwesterly along said shore line of Lake Leland to intersect a straight line that runs Southwesterly on an angle of 95° 56' to the left from the True Point of Beginning; thence Northeasterly along said straight line to the true point of beginning; Situate in the County of Jefferson, State of Washington.