HomeMy WebLinkAbout88052REA__.ESTATE EXCISE TAX AFFIDAV'
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QThis form is your receipt when
stamped by cashiers
PLEASF+ P, 4QR PRINT
PLEASE SEE REVERSE
CHAPTER 82.45 RCW - CHAPTER 458-61 WAC
For Use at County Treasurer's Office
(Use Form No. 84-001b for Reporting Transfers of Controlling Interest of Entity Ownership to the Department of Revenue)
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS 1-7 ARE FULLY COMPLETED
0 415a
1
Name RAINIER CONSTRUCTION EQUIPTMENT CO., A
2
Name PORT LUDLOW, L.L.C., A WASHINGTON LIMITED
G s
R E
N L
OR R
WASHINGTON CORPORATION
G B
R U
N E
E R
LIABILITY COMPANY
Street P.O. BOX 14135
Street 2737 78TH AVENUE SE, STE 201
City/State/Zip SEATTLE, WA 98114
City/State/Zip MERCER ISLAND, WASHINGTON 98040
3
I
ADDRESS TO SEND ALL PROPERTY RELATED CORRESPONDENCE
SEE GRANTEE ABOVE
ALL TAX PARCEL NUMBERS
990 300 127
COUNTY TREASURER PLACE
ASSESSED VALUE IF TAX EXEMPT
Name
Street
City/State/Zip
LEGAL DESCRIPTION OF PROPERTY SITUATED IN fa( UNINCORPORATED JFFFFRSON
COUNTY ❑ OR IN CITY OF
Street Address (if property is improved): THE ADMIRALTY UNIT 27, PORT LUDLOW, WASHINGTON 98365
SEE LEGAL DESRIPTION ATTACHED AS EXHIBIT "A" AND BY THIS REFERENCE MADE A PART HEREOF.
5
Is this property currently:
Classified or designated as forest land?
Chapter 84.33 RCW
YES NO
❑ N
Classified as current use land (open space, farm ❑
and agricultural, or timber)? Chapter 84.34 RCW
Exempt from property tax as a non profit
organization? Chapter 84.36 RCW
Seller's exempt Reg.NO.
Receiving special valuation as historic ❑
Property. Chapter 84.26 RCW
Property Type: ❑ land only
X land with previously used building
❑ timber only
Property Use: ❑ Apt. (4 + unit)
❑ timber 0 agricultural
❑ other
❑
❑ land with new building
0 land with mobile home
❑ building only
gicresidential
0 commercial/industrial
6
8
(1) NOTICE OF CONTINUANCE (RCW 84.33 OR RCW 84.34)
If the new owner(s) of land that is classified or designated as current use or
forest land wish to continue the classification or designation of such land, the
new owner(s) must sign below. If the new owner(s) do not desire to continue
such classifcation or designation, all compensation or additional tax calculated
pursuant to RCW 84.33.120 and 140 or RCW 84.34.108 shall be due and
payable by the seller or transferor at the time of sale. The county assessor must
determine if the land transferred qualifies to continue classification or
designation and must so indicate below. Signatures do not necessarily mean
the land will remain in classification or designation. If it no longer qualifies,
it will be removed and the compensating taxes will be applied.
All new owners must sign.
This land 0 does 0 does not qualify for continuance.
Date:
DEPUTY ASSESSOR
(2) NOTICE OF COMPLIANCE (Chapter 84.26 RCW)
If the new owner(s) of property with special valuation as historic property wish
to continue this special valuation the new owner(s) must sign below. If the new
owner(s) do not desire to continue such special valuation, all additional tax
calculated pursuant to Chapter 84.26 RCW, shall be due and payable by the
seller or transferor at the time of sale.
(3) OWNER(S) SIGNATURE
PERJURY:
Description of tangible, personal property if included
m sale (furniture, appances, etc.)
If exemption claimed, lis
WAC NO. (Sec/Sub)
Explanation:
er and explanation.
Type of Document STATUTORY WARRANTY DEED
Date of Document OCTOBER 4, 1999
Gross Sale Price $ 120,000.00
Personal Property (deduct) $
Taxable Sale Price $
Excise Tax: State $
Local $
Delinquent Interest: State $
Local $
Delinquent Penalty: State $
Local $
120.000.00
-1vgsfree- CD
Total Due $ 1,836.00
A MINIMUM OF $2.00 IS DUE AS A PROCESSING FEE AND TAX
7
AFFIDAVIT
I certify under penalty of perjury under the laws of the state
of Washington that the foregoing is true and correct (See last
page of this form)
Signature of,
Grantor/Agee,
Name (print) LLOYD WIEBE, SECRETARY
Date and Place of Signing:
Signature of
Grantee/Agent
Name (print) JAMES T. CASSAN, MANAGER
Date and Place of Signing:
tL CJ
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 840001a(6-16-95)(PD 6-19-95)
FOR TREASURER'S USE ONLY
COUNTY ASSESSOR-
0 8 8 0 5 2
$i xt43* xt)O
EXHIBIT A
LEGAL DESCRIPTION FOR: CTC - 35178
APARTMENT NO. 27, THE ADMIRALTY, A CONDOMINIUM AS SHOWN ON SURVEY MAP AND
FLOOR PLANS RECORDED APRIL 28, 1969, IN VOLUME 10 OF OFFICIAL RECORDS, PAGES
22 TO 35 INCLUSIVE, UNDER.AUDITOR'S FILE NO. 200065, AND AS IDENTIFIED IN
DECLARATION RECORDED APRIL 28, 1969, IN VOLUME 10 OF OFFICIAL RECORDS, PAGES
36 TO 42 INCLUSIVE, UNDER AUDITOR'S FILE NO. 200066.
TOGETHER WITH AN UNDIVIDED 2.69%- INTEREST IN COMMON AREAS AND FACILITIES
DESCRIBED IN PARAGRAPH 4 OF SAID DECLARATION.
SITUATE IN COUNTY OF JEFFERSON, STATE OF WASHINGTON.
ex -a 1/97