HomeMy WebLinkAboutC_Reeta_JungResidence_230310_V4Department of� Revenue{� Rea I" E�ta�e Excise Tax Affidavit (Rew a2.4s wAc 458-61A) Only for sC\les in a single location code on or after January 1 2023 Washington State
Form 84 0001 a T�!s affidavit will not ?e accepted unless all areas on all pag�s are ·fully and accurately compl t d T is form is your receipt when stamped by cashier. Please type or print. e e ·
IZ] Check box if partial sale, indicate %.1l!L_ sold. 1 Seller/Grantor
List percentage of ownership acquired next to each name.
2 Buyer/Grantee Name Charles H Jung & Connie Y Jung a Married Couple and Joseph C Jung, an unmarried person Name City of Renton A Washington Municipal Corporation
Mailing address 4580 Klahanie Dr. SE StE 188
City/state/zip Sammamish WA 98056 Malling address 1055 South Grady WA City/state/zip Renton WA 98057 Phone (including area code) ..,4""2�5-�6::::33::...-!:::23�3�5 ________ _ Phone (Including area code) ______________ _
3 Send all property tax correspondence to: IZl Same as Buyer/Grantee
Name _____________________ _
Mailing address __________________ _
City/state/zip __________________ _
List all real and personal property tax parcel account numbers
3342100940
Personal property? □ □ □
Assessed value(s)
$ 6 868.55
$ 0.00
$ 0.00
4 Street address of prope�'r.f'=1=:00=8=N=28=t=h=P=L=======;-------------------------�is property.is located in \Renton ! (for unincorporated locations please select your county) Check box 1f any of the hsted parcels are being segregated from another parcel, are part of a boundary line adjustment or parcels being merged. Legal descriotion of propertv (if vou need more soace, attach a separate sheet to each page of the affidavit). The south 1.5 feet (one feet six inches) of lot 41, block 1 2, hillman's lake washington garden of eden addition to seattle no. 1, according to the plat hereof recorded in volume 11 of plats, page 63, records of king county, washington.
5 §s -Highway and street right of way El Enter any additional codes ______________ _ (see back of last page for instructions) Was the seller receiving a property tax exemption or deferral under RCW 84.36, 84.37, or 84.38 (nonprofit org., senior citizen or disabled person, homeowner with limited income)? D Yes IZl No 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 classifications, complete the predominate use calculator (see instructions) □Yes IZl No
7 List all personal property (tangible and intangible) included in selling price.
If claiming an exemption, list WAC number and reason for exemption. WAC number (section/subsection) ____________ _ Reason for exemption
6 Is this property designated as forest land per RCW 84.33? □Yes IZINo
Is this property classified as current use (open space, farm Type of document ..:D:.aea.::e.::.d..::oc:..f .::.de:::,d::.:;ic,,,a .. ti.::.O:.:.n ___________ _
and agricultural, or timber) land per RCW 84.34? D Yes IZl No Date of document -=3,_,/9"'/2::.:0 .. 2"'3'----------------
Is this property receiving special valuation as historical property per RCW 84.26?
If any answers are yes, complete as instructed below.
DYeslZINo
(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
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% _______ ..::0c:.:.0=0
From $525,000.01 to $1,525,000 at 1.28%------�0.�00�
From $1,525,000.01 to $3,025,000 at 2.75% _______ �0�.0�0
Above $3,025,000 at 3% ______ �0.�00,._
Agricultural and timberland at 1.28%-------�0-�0�0
Total excise tax: state -------�0.�0�0
0.0050 Local ------�Ol:..\.0�0
*Delinquent interest: state _______ ..;0�-�00�
Local ------�0�.0�0
• Delinquent penalty -------�0,::,0�0
Subtotal ______ _.:0c:.:.0=0
•state technology fee _______ ...;5,., . .:.00,._
Affidavit processing fee 5.00
Total due 10.00
A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX *SEE INSTRUCTIONS
I CERTIFY UNDER PENALTY OF !E��ORRECT
y,J:,,J�.:ic>L!��-K-:,...,,.:;a:�.p:.�,-��Signature of grantee or agent __________ _
Name (prlntl--------------
Date & city of signin Date & city of signing ____________ _
Perjury in the second degree Is a class C felony which Is punishable by confinement In a state correctional institution for a maximum term 00ff0i2\ Y{)a(rs))' or by
a fine in an amount fixed by the court of not more than $10,000, or by both such confinement and fine (RCW 9A.72.030 and RCW 9A.2 · r c ·
To ask about the avallablllty of this pub.Uc;atlon In an alternate forrn�t for the vl�uallY. Impaired, please call 360-705•6705. Teletype (TTY) users may use the WA Relay Service by call ng 711.
REV 84 0001a (12/1/22) THIS SPACE TREASURER'S USE ONLY COUNTY TREASURER
Print on legal size paper. Page 1 of6