HomeMy WebLinkAbout125295 rep?Department of e- t2G ` r
This form is your receipt '
. evenue
Washiwoa State
1 ,
PLEASE TYPE OR PRINT REAL ESTATE EXCISE TAX AFFIDAVIT 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.81853JMM
0 Check box if partial sale of property If multiple owners,list percentage of ownership next to name
I. Name Jeffrey Schmidt and Julianne Schmidt,husband Name Mark Allan Schuler and Debra Ruth Schuler,
and wife Trustees of Schuler Trust Agreement dated April 9,
2014
c= O Mailing Address 23414 Rhododendron Ln NW ct w Mailing Address 11210 Olympic View Rd NW
w City/State/Zip Poulsbo,WA 98370 i City/State/Zip Silverdale,WA 98383 •--- COWL?
r7 Phone No.(including area code) (614)208-1431 :7 Phone No.(including area code) (360)692-7635
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
Schuler Trust Agreement dated April 9,2014,Mark 159,120.00
Name Allan Schuler and Debra Ruth Schuler,Trustees 992 600 020/41964 ❑
Mailing Address 11210 Olympic View Rd NW ❑
City/State/Zip Silverdale,WA 98383 ❑
Phone No.(including area code) (360)692-7635 ❑
® Street address of property: 7583 Thorndyke Road,Quilcene,WA 98376
This Property is located in unincorporated Jefferson County OR within❑city of Quilcene
❑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 0 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
MI YES NO
Is this property designated as forest land per chapter 84.33 If claiming an exemption,list WAC number reason for exemption:
RCW? ❑ 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
❑ x
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 April 15,2016
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 $ 199,000.00
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 $ 199,000.00
This land ❑does Excise Tax: State $ 2,547.20
❑does not qualify for continuance
Local $ 995.00
*Delinquent Interest: State $
Local $
DEPUTY ASSESSOR DATE *Delinquent Penalty $
(2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) Subtotal $ 3,542.20
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 $ 3,547.20
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",'� t ". PRINT AP fE A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX
e yr 4 i.�-(14_4.n2. EC-}tirii�, .. *SEE INSTRUCTIONS
® I CE FY 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) Jeffrey Schmidt Name(print) Schuler Trust Agreement dated April 9,2014
Date&city of signing: �'//2y/140 'Kb Dil bs, GUA Date&city of signing feA,y. /6, Le`:)ie..., C Z,,,P= AU,
Perjury: Perjury is a class C fel ny which is punishable by imprisonment in the state correctional institution for a maximum term of not more than fiv 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
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EXHIBIT A
Tract 14 of Seahome, as per plat recorded in Volume 2 of Plats, page 124, records of Jefferson County, Washington;
EXCEPT right-of-way for county road;
TOGETHER WITH all tidelands of the second class, extending to the line of mean low tide, as conveyed by the State
of Washington, situate in front of, adjacent to and abutting upon the above described uplands.
Situate in the County of Jefferson, State of Washington.