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HomeMy WebLinkAbout125360 Department of 1 t k(it �`1 ! ?C c, .Revenue t- ;�; Washington State 1.5 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. 111 Timothy A.Ruybalid and Marion K.Isherwood Ruybalid,husband and wife and Janet Isherwood,an Name unmarried person Name Kathleen Anne Magnuson,an unmarried person a w a Mailing Address PO Box 104 Mailing Address 38-5688 152nd Street d a City/State/Zip Walla Walla,WA 99362 XI a City/State/Zip Surry,BC V353K-2000 L.Phone No.(including area code) (360)774-1760 c. Phone No.(including area code) (604)531-8772 • 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 Kathleen Anne Magnuson 948603110 ❑ $292,535.00 Mailing Address 38-5688 152nd Street ❑ City/State/Zip Surry,BC V353K-2000r ? " 0 ii Phone No.(including area code) (604)531-8772 ❑ Q Street address of property: 131 Louisa Street,Port Townsend,WA 98368-8714 This property is located in❑unincorporated Jefferson County OR within®city of Port Townsend 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) FULLY DESCRIBED IN EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF. ® Select Land Use Code(s): Q List all personal property(tangible and intangible)included in selling 11 price. enter any additional codes: (See back of last page for instructions) YES NO Is this property exempt from property tax per chapter ❑ 84.36 RCW(nonprofit organization)? isYES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? ❑ ® WAC No.(Section/Subsection) Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? ❑ 0 Reason for exemption Is this property receiving special valuation as historical 0 property per chapter 84.26 RCW? If any answers are yes,complete as instructed below. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Type of Document Statutory Warranty Deed NEW OWNER(S): To continue the current designation as forest land or classification as current use(open space, farm and agriculture,or timber) Date of Document May 9,2016 land, you must sign on (3) below. The county assessor must then determine if the land transferred continues to qualify and will indicate by Gross Selling Price $ 339,000.00 signing below. If the land no longer qualifies or you do not wish to *Personal Property(deduct) $ continue the designation or classification, it will be removed and the compensating or additional taxes will be due and payable by the seller or Exemption Claimed(deduct) $ No transferor at the time of sale. (RCW 84.33.140 or RCW 84.34.108).Prior Taxable Selling Price $ 339,000.00 to signing(3)below,you may contact your local county assessor for more Excise Tax: State $ 4,339.20 information. This land 0 does 0 does not qualify fr continuance. Local $ 1,695.00 *Delinquent Interest: State $ DEPUTY ASSESSOR DATE Local $ (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Penalty $ NEW OWNER(S): To continue special valuation as historic property, Subtotal $ 6,034.20 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 $ 6,039.20 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 ,^ Signature of �� ►_ V � (_.--- Grantor or Grantor's Agent __, . D) Grantee or Grantee's�A/g�e�n�t� c��" Name(print) Timothy A.Ruybalid Name(print) i/414mAk (.if fhtee rine Magnuson Date&city of signing: 02 J1 QA 'EDLJ Date&city of signing: rj 1 it Zp lei 19Ol'( 71401 4()%4 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)). 1 - ,0:7.?� :,20* COUNTY TREASURER s er EXHIBIT "A" That portion of Eisenbeis Bay View Addition as recorded in Volume 2 of Plats,page 54,records of • Jefferson County,Washington,including streets and alleys as vacated by Jefferson County Superior Court Cause No.05-2-00382-0 being a portion of Section.16,Township 30 North,Range I West, W.M.,Jefferson County,Washington,described as follows: Beginning at the Southwest corner of said Section 16; Thence South 88° 15'53"East along the South line thereof,also being the South line of said Eisenbeis Bay View Addition,a distance of 1,192.57 feet to a point on the Westerly margin of State Highway 20; Thence North 07°08'39"East along said Westerly margin,a distance of 399.94 feet•, Thence North 88° 16'49"West a distance of 51534 feet; - Thence South 00°55'02"West,a distance of 154.90 feet to the true point of beginning; • Thence continuing South 00°55'02"West,a distance of 113.81 feet; • Thence South 880 16' 12"East,a distance of 190.00 feet; Thence North 00°55'02"East,a distance of 113.85 feet; Thence North 88° 16'49"West,a distance of 190.00 feet to the true point:of beginning. • Situate in the County of Jefferson,State of Washington.