HomeMy WebLinkAboutL-Reeta-Voyager34th-220114-V2[18410].pdfReal Estate Excise Tax Affidavit (Rcws2.45WAC458-61A)
Only fo'. sal?s i~ a single location code on or after January 1, 2023.
This affrdavrt wrll not be accepted unless all areas on all pages are fully and accurately completed.
This form is your receipt when stamped by cashier. Please type or print. Washin,,uon Srarc
Form 84 0001 a
0 Check box If partial sale, indicate %.1J!L_ sold.
1 Seller/Granter
list percentage of ownership acquired next to each name.
2 Buyer/Grantee
Name Laura L Ambrose
Brian Ambrose
Mailing address ..c10,c1,,22N:,..,c34,;th"-"'Sls., ------------
City/state/zip Renton WA 98056
Phone (including area code)--------------
3 Send all property tax correspondence to:O Same as Buyer/Grantee Name ___________________ _
Mailing address ________________ _
City/state/zip _________________ _
Name City of Renton A Washington Municipal Corporation
Mailing address 1055 South Grady WA
City/state/zip Renlon WA 98057
Phone (including area code) _____________ _
List all real and personal property tax
parcel account numbers
Portion of 3342102710
Personal Assessed
property? value(s)
0 $5,694.44
0 ~$=0-=00~--
0 $ 0.00
4 Street address of proper;,rty~10~1~2c:N=34~th=S~t========,;:;a;;------------------------
This property is located in !Renton B (for unincorporated locations please select your county} D 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 you need more soace, attach a separate sheet to each page of the affidavit).
he south one foot, six incesh of proeprty described as lot 41 and the east half of lot 42, block 19 hillman
Is lake washington garden of eden addtion to seattle no. 1 according to the plat thereof recorded in volumne 11 of plats, page 68, records of king
icounty, washington, situate in teh county of king, state of washington.
5 @5 -Highway and street right of way 0
Enter any additional codes _____________ _
(see back of last page for instructions)
7 List all personal property (tangible and intangible) included in selling
price.
Was the seller receiving a property tax exemption or deferral under RCW 84.36, 84.37, or 84.38 (nonprofit org., senior If claiming an exemption, list WAC number and reason for exemption.
citizen or disabled person, homeowner with limited income)? D Yes '21 No WAC number (section/subsection) ___________ _
Is this property predominately used for timber (as classified
under RCW 84.34 and 84.33) or agriculture (as classified under
RCW 84.34.020) and will continue in it's current use? If yes and
the transfer involves multiple parcels with different dassific.ations,
complete the predominate use calculator (see instructions) i2)No
6 Is this property designated as forest land per RCW 84.33? Dves '21 No
Reason for exemption
Type of document Deed of dedication Is this property classified as current use (open space, farm
and agricultural, or timber) land per RCW 84.34? D Yes i2I No Date of document a1'-'/1o,3'-'/2"'02.,3,__ ____________ _
Is this property receiving special valuation as historical
property per RCW 84.26?
lf any answers are yes, complete as instructed below.
(1) NOTICE OF CONTINUANCE (FOREST LAND OR CURRENT USE)
NEW OWNER{S): To continue the current designation as forest land
or classification as current use {open space, farm and agriculture, or
timber) 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. If the land no longer qualifies or you do not wish to
continue the designation 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 84.33.140 or 84.34.108). Prior to
signing (3) below, you may contact your local county assessor for more
information.
This land:
continuance.
Odoes
Deputy assessor signature
D does not qualify for
Date
(2) NOTICE OF COMPLIANCE (HISTORIC PROPERTY)
NEW OWNER(S): To continue special valuation as historic property, sign
(3) below. If the new owner(s) doesn't wish to continue, all additional tax
calculated pursuant to RCW 84.26, shall be due and payable by the seller
or transferor at the time of sale.
(3) NEW OWNER(S) SIGNATURE
Signature Signature
Print name Print name
81 CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS T
Signature of granter or agent ~/ •
Name (print) Ov""""-l.. l\ .. ~rO u_ //J
Date & city of signing / •I'/-:).. '3 \-• 11,
Gross selling price ______ __,0".0""-0
"Personal property (deduct) ______ __,0".0=0
Exemption claimed (deduct) ______ __,0".0=0
Taxable selling price ______ __,0".0"'-0
Excise tax: state
Less than $525,000.01 at 1.1% ______ __,0"".0""-0
from ss2s,ooo.01 to s1,s2s,ooo at 1.28% ______ __,0"'.0"'-0
from $1,525,000.01 to $3,025,000 at 2.7S% ______ __,Oe:.0=0
Above $3,025,000 at 3% ______ __,0<c.0,,cO
Agricultural and timberland at 1.28% ______ ___,,Oc,.0"'-0
Total excise tax: state ______ ___,,Oc,,0"'-0
0.0050 Local ______ _,Oc,.0,,cO
•Delinquent interest: state ______ ___,,Os,.0"'-0
Local ______ __,Os,.O<e..0
•Delinquent penalty ______ __,0"-.0""-0
Subtotal ______ __,Oc,.O,,,_O
•state technology fee ______ __,5"'.0""-0
Affidavit processing fee _______ 5"'.=00
Total due 10.00
A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX
"SEE INSTRUCTIONS
CORRECT
i ature of grantee or agent _________ _
Name (print) ______________ _
Date & city of signing
Perju~i~e1~'asne~a,;:u ~~,r:eedit~ f ~!s~;ufr~1~FX;f ~ctr: fh~~iSh1~~beo~~ ~o5~fi~ee~!~~c~~0d"fi~i;(~~~~1~?1.iroa:~d~~Jve;~.r 6.f~~~ (1)(~)). or by
To ask about the availability of this publication in an alternate format for the visual I~ impaired, please call 360-705-6705. Teletype (TTY) users may use the WA Relay Service by calling 711.
REV 84 0001, 112/1/221 THIS SPACE TREASURER'S USE ONLY COUNTY TREASURER
Print on legal size paper.
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