HomeMy WebLinkAbout37859 CHAPTER 28.45 RCW L
joofre4'
PLEASE FILL OUT COMPLETELY
Parcel Number 1% REAL ESTATE EXCISE TAX 1 1 V is Segregation
Required Yes Q
MAKE REMITTANCE PAYABLE TO JEFFERSON COUNTY TREASURER
No Q
NAME
NAME OF SELLER AND COMPLETE ADDRESS
ADDRESS
NAME
NAME OF BUYER AND COMPLETE ADDRESS ',3� r1 �_�
ADDRESS
• Send Statement to:
Legal description of real property situated in JEFFERSON COUNTY
DESCRIPTION OF PERSONAL PROPERTY IF INCLUDED IN SALE If tax exemption is claimed,explain fully the nature of the transfer.
GROSS SALES PRICE 1% EXCISE TAX
(equity plus obligated balance) $ (Payable within 30 days of date of sale) $
PERSONAL PROPERTY (deduct) $ PENALTY (1% per month) $
TAXABLE SALES PRICE $ TOTAL $
DATE OF INSTRUMENT AFFIDAVIT
(On date of delivery of instrument if that is the closing date provided in The undersigned being first sworn, on oath says that the foregoing is a
contract; otherwise upon execution of contract) true and correct statement of the facts pertaining to the transfer of the
above described real estate.
TYPE OF INSTRUMENT
If sale covers property traded in under R.C.W. 28A.45.105 give date and SIGNATURE
affidavit number of prior sale.
DATE AFFIDAVIT NO. Any person willfully giving false information in this affidavit shall be subject
to the PERJURY LAWS of the State of Washington.
TYPE OF PROPERTY? ❑ Commercial ❑ Residential
❑ Agricultural ❑ Industrial ❑ Recreational
❑ Mobile Home Site ❑ Multiple Dwelling ❑ Bare Land
Does sale include current crop? ❑ YES ❑ NO Subscribed and sworn to before me this day
Served by a public sewer? El YES ❑ NO of , 19
Does sale price include real estate commission? ❑ YES ❑ NO
Notary Public in and for the State of Washington
If more than one county parcel number,will property
be used as a single parcel? El YES ❑ NO residing at
Will this property be used with any adjoining
property presently owned by the purchaser? ❑ YES ❑ NO PROCESSED BY AFFIDAVIT NUMBER
Does this conveyance involve ? ❑ Partial Interest
❑ Corporate affiliations ❑ Related Parties
❑ Trust Agreement ❑ Estate Property DEPUTY
❑ Trade ❑ Life Estate
THIS BOX FOR STATE DEPARTMENT OF REVENUE USE ONLY
A.V. CLASS
"khat p ori;ion of the Southwest Quarter of theSouthwest Quarter and the
Southeast Quarter of the Southwest Quarter and the Northeast Quarter of
the Southwest Quarter of Section 2 , Township 29 North, Range 1 West , W.M.
Jefferson County, Washington, described as follows :
Beginning at the Southeast Corner of said Southwest Quarter of the
Southwest Quarter; thence North 1°56 ' 01 ' East along the East
line of said Southwest Quarter of the Southwest Quarter, a distance
of 847. 76 feet to the Southwest .Corner of the North 495 feet of I 'f
said Southeast Quarter of the Southwest Quarter;v%hence South
87°21 ' 28" East along the South line of said North 495 feet ; a
distance of 755 feet ; thence North 1°50 '.59" East, a distance of
599. 38 feet ; thence North 26°37 ' 09" West , a distance of 300 . 00
feet to the South Margin of the existing County Road known as the
New Hadlock Road;✓thence Southwesterly along said South Margin,
approximately 166D feet to the Centerline of Chimacum Creek;
thence Southerly along said Centerline, approximately 972 feet to
the South line of said Southwest Quarter of the Southwest Quarter ;
thence South 88°46 ' 27" East , approximately 572 feet to the POINT
OF BEGINNING.
EXCEPT that portion, if any, lying within the South 825 feet of the
East Half of the Southeast Quarter of the Southwest Quarter of
said Section 2 .
EXCEPT right-of-way appropriated by Drainage District No. 1 in
Jefferson County Superior Court Cause No. 3193.
Situated in Jefferson County, Wasington. �U'�`