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HomeMy WebLinkAbout125461 G. —(A±k 02' Department of Revenue te REAL ESTATE EXCISE TAX AFFIDAVIT Washington State This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61A WAC when stamped by cashier. 1c---ti` S-t? THIS AFFIDAVIT WiLL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED (See back of last page for instructions) Check box if partial sale of property If multiple owners,list percentage of ownership next to name. © Name: U.S. Bank National Association,as Trustee forName: Kurtis Guth and Laura Guth, husband and wife GSR Mortgage Loan Trust 2006-1F, Mortgage Pass- es Thrn.inh Cp,+ifirat, c Cariac 7nflf+-1 F w Mailing Address 8950 Cypress Waters Boulevard w z Mailing Address 1023 Dead Run Drive .J za City/State/Zip Coppell,TX 75019 m R City/State/Zip McLean,VA 22101 c. Phone No.(including area code) Phone No.(including area code) III Send all property tax correspondence to: X Same as Buyer/Grantee List all real and personal property tax parcel account List assessed value(s) numbers-check box if personal property � Name 001302008 f \V�J'q I 1 I 515 ) ). 'U° Mailing Address IN( 3 City/State/Zip vt/t Phone No.(including area code) I I I ,i af) - © Street address of property: 6120 Ca,V.George Rd, Port Townsend,WA 98368 This property is located in Port Townsend II 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) Parcel 25,of survey recorded in Volume 8 of Surveys, page 126, recorded under Auditor's File No. 307173,being a portion of Sections 19 &30,Township 30 North, Range 1 West,W.M.,Jefferson County,Washington.Situate in the County of Jefferson,State of Washington. ® Select Land Use Code(s): 0 List all personal property(tangible and intangible)included in selling 11 price. enter any additional codes: (See back of last page of instructions) YES NO Was the seller receiving a property tax exemption or deferral I i X under chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior citizen,or disabled person,homeowner with limited income)? © 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? X Is this property classified as current use(open space,farm and I Xi WAC No.(Section/Subsection) agricultural,or timber)land per Chapter 84.34 RCW? Is this property receiving special valuation as historical property I XI Reason for exemption 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 Special Warranty Deed NEW OWNER(S): To continue the current designation as forest land or classification as current use(open space,faun and agriculture,or timber)land,you Date of Document April 26, 2016 must sign on (3) below. The county assessor must then detennine if the land transferred continues to qualify and will indicate by signing below. If the land no Gross Selling Price $ 444,150.00 longer qualifies or you do not wish to continue the designation or classification,it *Personal Property(deduct) $ will be removed and the compensating or additional taxes will be due and payable Exemption Claimed(deduct) $ by the seller or transferor at the time of sale. (RCW 84.33.140 or RCW 84.34.108). Prior to signing(3)below,you may contact your local county assessor Taxable Selling Price $ 444,150.00 for more information. Excise Tax : State $ 5685.12 This land does does not qualify for continuance. .500 Local $ 2220.75 *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,sign(3) Subtotal $ 7905.87 . below. If the new owner(s)does not wish to continue,all additional tax calculated pursuant to chapter 84.26 RCW,shall be due and payable by the seller or transferor *State Technology Fee $ 5.00 at the time of sale. *Affidavit Processing Fee $ (3)OWNER(S)SIGNATURE Total Due $ 7910.87 A MiNIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX PRINT N AME *SEE INSTRUCTIONS 8 I C TIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AN P,C e •RECT. Signature of — /'� Signature of Grantor or Grantor's Age ,d Grantee or Grantee' nt 4 Name(print) Marianne Lisst?n-FATCO Name(print) Marianne Lissont ATCO Date&city of signing: Or Il116 Puyallup Date&city of signing: flunib Puyallup 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)). 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