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HomeMy WebLinkAbout125474 . r-e‘'L Department of rt121, 6d. ' l 2 !c. Revenue Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-6I A 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. Name MTC Financial Inc.dba Trustee Corps 11 Name FEDERAL NATIONAL MORTGAGE ASSOCIATION Ic/o BANK OF AMERICA,N.A. Mailing Address 500 Union Street,Suite 620 Mailing Address 7105 Corporate Drive City/State/Zip Seattle,WA 98101 City/State/Zip Plano,TX 75024 Phone No.(including area code) (800)367-8456 Phone No.(including area code) 800-669-6607 © List all real and personal property tax parcel account List assessed value(s) Send all property tax correspondence to: Same as Buyer/Grantee numbers-check box if personal property () Name 994 800 405 1 $172,514.00 Mailing Address City/State/Zip Phone No.(including area code) 11 Street address of property: 38 BRIGHTON ST,PORT HADLOCK,WA 98339-9508 This property is located in PORT HADLOCK 0 Check box if any of the listed parcels are being segregated from another parcel,are part of a boundary line adjustment or parcels being merged. Legal description of property(if more space is needed,you may attach a separate sheet to each page of the affidavit) SEE ATTACHED ®Select Land Use Code(s); 111 List all personal property(tangible and intangible)included in selling I—Household,single family units price: enter any additional codes: (See back of last page for instructions) YES NO Was the seller receiving a property tax exemption or deferral under 0 Chapters 84.36,84.37,or 84.38 RCW(nonprofit organization,senior citizen,or disabled person,homeowner with limited income)? YES NO If claiming an exemption,list WAC number and reason for exemption: Is this property designated as forest land per chapter 84.33 RCW? 0 WAC No.(Section/Subsection) 458-61 A-217 Is this property classified as current use(open space,farm and 0 0 �v'�,.�/ agricultural,or timber)land per chapter 84.34? Reason for exemption Co Tee Is this property receiving special valuation as historical property 0 per chapter 84.26 RCW? INSTRUMENT NO .504442-__ t 12,51 f Z, yi 8/ (p If any answers are yes,complete as instructed below. (1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Type of Document RE-RECORD OF TRUSTEE'S DEED INSTRUMENT#598547 NEW OWNER(S): To continue the current designation as forest land or Classification as Date of Document MAY 23,2016,SEATTLE current use(open space,farm and agriculture,or timber)land,you must sign on(3)below. The county assessor must then determine if the and transferred continues to qualify and will indicate by signing below. If the and no longer qualifies or you do not wish to Gross Selling Price$ 171,557.80 continue the designation or classification,it will be removed and the compensating or *Personal Property(deduct)$ additional taxes will be due and payable by the seller or transferor at the time of sale. Exemption Claimed(deduct)$ 171,557.80 (RCW 84.33.140 or RCW 84,34.108). Prior to signing(3)below,you may contact your Taxable Selling Price$ 0.00 local county assessor for more information. Excise Tax:State$ 0.00 This land 0 does 0 does not qualify for continuance. Local$ 0.00 *Delinquent Interest:State$ DEPUTY ASSESSOR DEPUTY ASSESSOR Local S (2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Penalty$ NEW OWNER(S):To continue special valuation as historic property,sign(3)below. If the Subtotal$ 0.00 new owner(s)does not wish to continue,all additional tax calculated pursuant to chapter *State Technology Fee$ 5.00 84.26 RCW,shall be due and payable by the seller or transferor at the time of sale. *Affidavit Processing Fee$ 5.00 (3)OWNER(S)SIGNATURE Total Due$ 10.00 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 1S TRUE AND CORRECT. Signature ofSignature of Grantor or Grantor's Agent Q) Grantee or Grantee's Agent P int ` ' Name(print) Raquel Hill Name(print) Raquel Hill Date&city of signing: MAY 23,2016,SEATTLE Date&city of signing: MAY 23,2016,SEATTLE 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 fiveyears,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 000Ia(2/24/14) • LEGAL DESCRIPTION LOT 5, BLOCK 4 OF SHOLD'S ADDITION TO HADLOCK, AS PER PLAT RECORDED IN VOLUME 4 OF PLATS, PAGE 2, RECORDS OF JEFFERSON COUNTY,WASHINGTON.