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HomeMy WebLinkAbout125355 a? 77 Department ofC(,� qRevenue - Washington State REAL ESTATE EXCISE TAX AFF DAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61 WAC when stamped by cashier. THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL 'AGES ARE FULLY COMPLETED (See back of last page for instructions) ❑ Check box if partial sale of property If mu tiple owners,list percentage of ownership next to name. InName Glenda J.Meek.Personal Representative of the Estate of ® Name Glend: J.Meek c4r Martin Scott Meek w a Mailing Address 302 Crutcher Road Mailing Addr ss 302 Crutcher Road w C7 City/State/Zip Port Townsend,WA 98368 c City/State/Zi. Port Townsend,WA 98368 Phone No.(including area code)(360)774-2444 Phone No.(i eluding area code)(360)774-2444 © Send all roe tax cones ondence to: ✓ Same as Bu er/Grantee List all real and personal .roperty tax parcel account p p p y numbers-check bo if personal property List assessed value(s) Name 001 181 022 0 $247,306 Mailing Address TAX E (r V.2.. • City/State/Zip n Phone No.(including area code) ❑ nh a p it - EllStreet address of property: 302 Crutcher Road,Port Townsend,WA 98368 r This property is located in Jefferson County 0 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) The East 1/2 of the South'1/4 of the West 1/2 of the Southeast 1/4 of the Northeast'/.of Section 18,Township 30 North,Range 1 West,W.M., EXCEPTING THEREFROM the South 30 feet as conveyed to Jefferson County for road by Deed recorded under Auditor's File No. 264423. Situate in the County of Jefferson,State of Washington. Select Land Use Code(s):It! II List all personal property(tangible and intangible)included in selling 11-Household,single family units 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 0 chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior citizen,or disabled person,homeowner with limited income)? If claiming an exe ption,list WAC number and reason for exemption: 6 YES NO Is this property designated as forest land per chapter 84.33 RCW? 0 ❑✓ WAC No. (Sectio /Subsection) 458-61A-202(0) Is this property classified as current use(open space,farm and 0 0l agricultural,or timber)land per chapter 84.34 RCW? Reason for exemp ion Inheritance or Devis Is this property receiving special valuation as historical property ❑ ❑✓ per chapter 84.26 RCW? If any answers are yes,complete as instructed below. Type of Document Personal Representative's Deed (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) A 1 3 I NEW OWNER(S):To continue the current designation as forest land or Date of Documents t"I q t.E 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 Gro s Selling Price $ land transferred continues to qualify and will indicate by signing below.If the *Personal Pr perty (deduct) $ land no longer qualifies or you do not wish to continue the designation or Exemption Cl imed(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 Taxab a Selling Price $ 0.00 84.33.140 or RCW 84.34.108).Prior to signing(3)below,you may contact Ex ise Tax: State $ 0.00 your local county assessor for more information. 0.0150 Local $ 0.00 This land 0 does 0 does not qualify for continuance. *Delinquen Interest: State $ Local $ DEPUTY ASSESSOR DATE *Del'nquent Penalty $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) NEW OWNER(S):To continue special valuation as historic property, Subtotal $ 0.00 sign(3)below,If the new owner(s)does not wish to continue,all *State echnology 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 1'rocessing Fee $ (3) OWNER(S)SIGNATURE Total Due $ 10.00 PRINT NAME A MINIM M 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 COR T Signature ofi Signature of Grantor or Grantor's Agentn-v..,0ylGrantee or Grantee's Agent . Name(print) Glenda J.Meek as Personal RIDresentativ j ` e (� Name(print) Gle da J.Meek Date&city of signing:Th'`1 - �� ''•a--4l-\211r.-1fs,Q�1� Date&city of signing:--\ "N ti,. -): may„ > 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 in-prisonment and fine(RCW 9A.20.020(1C)). REV 84 0001a(2/24/14) THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER