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HomeMy WebLinkAbout125498 Departme It: aue .a ICC' Washington tart State (7 -'(r ;5�1 REAL ESTATE EXCISE TAX AFFIDAVIT PLEASE TYPE OR PRINT CHAPTER 82.45 RCW—CHAPTER 458-61A WAC This form is your receipt 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. 0 Name Christina Engle,as her separate estate ®Name JoAnna Caro,an unmarried person cc aF Mailing Address 2981139th Ave.So. Mailing Address 50 S Chandler Ct Unit D Z a City/State/Zip Roy,WA 98580 co a City/State/Zip Port Ludlow,WA 98365 L.Phone No.(including area code) (360)301-5208 c Phone No.(including area code) (619)807-8537 IISend all property tax correspondence to:0 Same as Buyer/Grantee List all real and personal property tax parcel account numbers—chec box if ersonal property List assessed value(s) Name JoAnna Caro 961601004 � 5( `Yn 0 $143,400.00 Mailing Address 50 S Chandler Ct Unit D City/State/Zip Port Ludlow,WA 98365 0 - Phone No.(including area code) (619)807-8537 0 0 ©Street address of property: 50 S Chandler Ct Unit D,Port Ludlow,WA 98365 This property is located in 0 unincorporated Jefferson County OR within 0 city of Port Ludlow 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 14 price. enter any additional codes: (See back of last page for instructions) Is this property exempt from property tax per chapter YES NO 84.36 RCW(nonprofit organization)? ❑ El ® 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 El Is this roe 0 ® WAC No.(Section/Subsection) p p rty 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 El 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 16,2016 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 $ 239 000.00 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 $ 239 000.00 to signing(3)below,you may contact your local county assessor for more information. Excise Tax: State $ 3,059.20 This land 0 does 0 does not qualify for continuance. Local $ 1,195.00 *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 $ sign (3) below. If the new owner(s) does not wish to continue, all 4,254.20 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 $ 4,259.20 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 Grantor or Grantor's Agen> .r,< D Grantee or Grantee's Agent C` e,,(s.._ 00,.,,..a Name(print) Christina En le Name(print) JoAnna Caro Date&city of signing: OIL� �7—¢a,r, Date&city of signing: p S'%b - c. --?d,�„r T"owwtlawlb. 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)). 75r...-„:.,-.:%.:'• 1 2°-,49E :,,:t7,, :;2;1 c. 4 _.2 THIS SPACE—TREASURER'S USE ONLY COUNTY TREASURER 'i EXHIBIT "A" Apartment No. 10D,Building 10,of Inner Harbor Village,a condominium intended for residential use,according to the Condominium Plan and Survey Map delineating said apartment,recorded in Volume 1 of Condominiums,pages 156 through 160;pages .161 through 166; 167 through 171; 172 through 177;202 through 206;224 through 228;229 through 234;235 through 241;248 through 254; 261 through 266;and Volume 2 of Condominiums,pages 1 through 7 and 10 through 16;under Jefferson County Recording Nos. 329056;329608;330741;330742;337633;340777;340906; 340907;342342;345601;353091;355008;located in Port Ludlow; TOGETHER WITH an undivided 2.174%interest in the common areas and facilities appertaining to said apartment,and including therein limited common areas and facilities so appertaining,according to the Condominium Declarations recorded.,under Jefferson County Recording No.329057; Said Declaration and Plans are modified or amended by documents recorded under Jefferson County Recording Nos.329607,329608,330741,330742,337633,337634,338754,340777,340906, 340907,342341,342342,345600,345601,353061,353062,355007 and 355008; SUBJECT,however,to possible partial defeasance of this undivided interest,upon inclusion of the subsequent phase(s)to the condominium by recorded amendment to the Declaration; AND TOGETHER WITH that portion of the declarant's interest in the common areas and facilities of the property in any subsequently added phase(s),all as expressly provided for in the declaration,upon properly recorded amendments thereto. Situate in the County of Jefferson,State of Washington.