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HomeMy WebLinkAbout125425 Department:of U) s 3 5-teveee ntie ) lifl s irrrgton State ('( 4 1' REAL ESTATE EXCISE TAX AFFIDAVIT PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61A WAC whe fsn tm dour ca h e THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED ped by cashier. (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. Edward K.Winslow and Mary K.Winslow,husband Name Hattie Longmire,as her separate estateIII ©Name and wife 6_ oki.e.cr—szu1/4_ tin- a 5 s'-5)c 1 cc w F Mailing Address 405 3rd Ave North x w - z Mailing Address 501 Griffiths Point Rd rn a City/State/Zip Edmonds,WA 98020 City/State/Zip Nordland,WA 98358 co c4 L Phone No.(including area code) (425)678-0772 Phone No.(including area code) (360)536-1921 1111 Send all property tax correspondence to:0 Same as Buyer/Grantee List all real and personal property tax parcel account numbers-check box if personal property List assessed value(s) Name Edward K.Winslow&Mary K.Winslow 021324010 0 $463,876.00 Mailing Address 501 Griffiths Point Rd 7010( /0 L T rte-( t -J J 0 j, City/State/Zip Nordland,WA 98358 )A:9 J 0 Phone No.(including area code) (360)536-1921 Y L„_ PtCi ` ©Street address of property: 501 Griffiths Point Rd,Nordland,WA 98358 This property is located in®unincorporated Jefferson County OR within 0 city of Nordland 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. n 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 ❑ El 84.36 RCW(nonprofit organization)? 0 YES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? 0 IZI WAC No.(Section/Subsection) Is this property classified as current use(open space,farm and agricultural,or timber)land per chapter 84.34? ❑ ® 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 17,2016 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 $ 720 000.00 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 $ 720 000.00 to signing(3)below,you may contact your local county assessor for more } information. Excise Tax: State $ 9,216.00 This land 0 does 0 does not qualify for continuance. Local $ 3,600.00 *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 $ 12,816.00 sign (3) below. If the new owner(s) does not wish to continue, all additional tax calculated pursuant to chapter 84.26 RCW,shall be due *State Technology Fee $ 5.00 and payable by the seller or transferor at the time of sale. *Affidavit Processing Fee $ (3) OWNER(S)SIGNATURE Total Due $ 12,821.00 PRINT NAME A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX *SEE INSTRUCTIONS nI CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TR " • D /,41• ti Signature of /r Signature of Grantor or Grantor's Agen�/� /� • i .0. ,7_12 Grantee or Grantee's Agent Name(print) Hattie Longmire Name(print) Edward K.Winslow Date&city of signing: . /i '/'2c1/f /YXjsi'1(„S, WA Date&city of signing: ..S---%`yam 1 ( 7viut Cc /t f k 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(IC)). " :: 125435 =: ;' ;E;'' 'E_If.: i :Or!_'' ONLY COUNTY TREASURER • • EXHIBIT "A" A portion of Government Lot 8,Section 32,Township 30 North,Range 1 East,W.M.,more particularly described as follows: Beginning at a point 1,944.0 feet West of the Southeast corner of Section 32; thence North 21°West,a distance of 600 feet to the True Point of Beginning for this description; thence North 21°West a distance of 100.0 feet; thence West to the Westerly line of said Lot 8; thence Southeasterly along said Westerly line a distance of 100 feet,more of less,to a point due West of the True Point of Beginning; thence East to the True Point of Beginning and the end of the description. TOGETHER WITH the second class tidelands abutting upon the above described tract and lying • between the North and South boundaries when extended to the West. ALSO TOGETHER WITH an easement for ingress and egress over and across a road being constructed from county roadway to said Lot as disclosed by Auditor's File No.200889,recorded July 2, 1969,records of Jefferson County,Washington; ALSO TOGETHER WITH an easement for the installation,construction,use,maintenance, repair,replacement and related access to and from,for underground utilities,over,under and across a portion of Government Lot 8 in said Section 32,as delineated by Auditor's File No. 367447,recorded January 5, 1994,records of Jefferson County,Washington. Situate in the County of Jefferson,State of Washington.