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HomeMy WebLinkAbout125496 ` [:)rpxrtme t of -. .`.-- , (—Ca') I evenue -IL- v1/4,4,,,,,,,,,'uuu REAL ESTATE EXCISE TAX AFFIDAVIT '3/ �` This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-6IA 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) ❑Check box if partial sale of property If multiple owners,list percentage of ownership next to name. 1111 Name Quality Loan Service Corp.of Washington © Name U.S. Bank Trust,N.A.,as Trustee for LSF9 Master Participation* W at 1514Ac. .a` e; ie) t8(4 i/J w c/o Caliber Home Loans, Inc Z Mailing Address 108 1st Ave.South,Suite 202 w z '•lMailing Address 16745 West Bernardo Drive Suite 300 City/State/Zip Seattle,WA 98104 m City/State/Zip San Diego,CA 92127 Phone No,(including area code) ) I+ 5•b 39 93 Phone No,(including area code) 1 9 3 ® Send all property tax correspondence to:❑✓ Same as Buyer/Grantee List all real and personal property tax parcel account numbers—check box if personal property List assessed values) Name A.P.N.: 969912506 Q Mailing Addressri / � -* City/State/Zip 48/••o "��lL��CIP 39-LH-Li n 7 D )o(14�L. Phone No,(including area code) n L © Street address of property: 2095 LAWRENCE ST PORT TOWNSEND,WA 98368 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) LOT 8,BLOCK 125 MABEL ADDITION TO THE CITY OF PORT TOWNSEND,AS PER PLAT RECORDED IN VOLUME 2 OF PLATS, PAGE 12,RECORDS OF JEFFERSON COUNTY,WASHINGTON SITUATE IN THE COUNTY OF JEFFERSON,STATE OF WASHINGTON. *Trust 111 Select Land Use Code(s): III List all personal property(tangible and intangible)included in selling 11-Household,single family units price. enter any additional codes: -0 - (See back of last page for instructions) YES NO Is this property exempt from property tax per chapter 0 0 84.36 RCW(nonprofit organization)? © 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 ❑✓ Is this property classified as current use(open space,farm and ❑ 0 WAC No. (Section/Subsection) 458-61A-208(4) agricultural,or timber)land per chapter 84.34? Reason for exemption Is this property receiving special valuation as historical property 0 0 Foreclosure of Deed of Trust- 39,7,•7 i 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 Trustees Deed Upon Sale 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 5/24/16 land,you must sign on(3)below.The county assessor must then determine if the land transferred continues to qualify and will indicate by signing below, Gross Selling Price $ 198,334.37 If the land no longer qualifies or you do not wish to continue the designation *Personal Property (deduct) $ or 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 Exemption Claimed (deduct) $ 198,334.37 84.33.140 or RCW 84.34.108).Prior to signing(3)below,you may contact Taxable Selling Price $ 0.00 your local county assessor for more information. Excise Tax : State $ 0.00 This land 0 does 0 does not qualify for continuance. 0.0050 Local $ 0.00 *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, sign(3)below. If the new owner(s)does not wish to continue,all Subtotal $ 0.00 additional tax calculated pursuant to chapter 84.26 RCW,shall be due and payable by the seller or transferor at the time of sale. *State Technology Fee $ 5.00 (3) OWNER(S)SIGNATURE *Affidavit Processing Fee $ 5.00 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 F PERJURY THAT THE FOREGOING IS TRUE AN i CORRECT. !j Signature of Signature of Grantor or Grantor's Age Grantee or Grantee's Agent • V $ 0 b2.Lg Name(print) Janice Stavee Name(print) SIERRA HERBERT WEST Date&city of signing: 5/24/16 Seattle Date&city of signing: 5/24/16 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 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)). REV 84 0001ae(5/31/11) THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER j