HomeMy WebLinkAboutREETA MonterraDepanment ofRevenue
Washington State REAL ESTATE EXCISE TAX AFFIDAVIT
PLEASE TYPE OR PRINT CI-IAPTER 82.45 RCW —CHAPTER 458-6 IA WAC
THISAFFIDATf Will.NOT HE ACCEPTED UNLESS ALLAREAS ON ALL PAGES ARE FILLYCOMPLETED
(Set back of last pale for inslructions)
Eulterk box if partial sale,Indicate %489 sold.List perrentane ofownenhip acquired next to earls nan.
A Name Pool Brothers Construction ‘came City of Renton
q %Mailing .\ddress 720 North 1 0th Street.Suite #Al 05 P Mailing Ad&s 1055 South Grady Way
City SlaleZip Renton.WA 98057 (Thy Stale Zip Renton,WA 98057
Iionc No.(iocludine area code)—Phone No.(including area codc)(425)430-6400
fl Send all pmpcdv tax correspondence to:Same as BuverGrantcc List all real and Personal prnpefl lax parcel account List assessed value(s)
.numbers —check box ilpenonal property
Name 3119900051 —D
Mailing Address
Cit\State Zip I—i
Phone No.(including area code)____________________________________________
Slrcct address of property:900 Sunset Boulevard Nodhest,Renlon,WA
This properly is localcd in Renton
Q Check box ifany oftlse listed parcels are being segregated 1mm anotlser parcel.are pan ofa houndan’line adjustment or parcels being merged.
Legal descriplion of properly (if more space is needed,you may attach a separate shed to cad,page of ltsc affidavit)
A PORTION OF PARCELS OF 907 ABERDEEN ABERDEEN AVE LOT UNE ADJUSTMENT LUA-06-12&LLA RECORDED MARCH
20,2007 UNDER RECORDING NUMBER 20070320903004,IN ThE OFFICIAL RECORDS OF KING COUNTY,WASHINGTON
de(s):
£5 -r4i1
enter any addilional codes:__________________________________
(See t,ack of last page for iisslruclioiis)
YES NO
Was titc seller tehing a pmrrt lasexcniptiui or deferral under Q
chapters 8436.8337.orPs338 RCW(nonpmtitoipttiznlion.senior
ctlizns,or dtsableri pr [Is,Iiomc’onersitIi limited income)?
fl
Is this propat’desienated as fowst land per chapter 8433 RCW?
Is this pmpeflv classified as nintut use (open spane.fans,and
awicultitra].or timber)land perclsaptc’r843-I RCW?
Is this pmpedv reccising sjxdal valuation as lusioricul ptopdv D E
per cluplt 8426 RCW?
If msv alstc’rs moves,complete as tnslnictcd beIos,
(t)NOTICE OvcOrs’FLWANLl’:([XJRESI I.\NDORCURRENT USE)
NEW OWNERS):To cclititiuc (lie clintist designation as fowat haid or
classification as current use (opas space.t’anti and agrictiltitre,or timber)land.
tiu nsust sign on (3)below.The ctnutttv asiessor ssiost then detemune iftite
land tmi,stcrwd continues to qualift atid sill tisdtcate by signing below.If the
land no longer qitalifies or you do not sisit to continue the designation or
classification,it “ill be removed mid tlse coinpeusaling or additional taxes isill
be doe mid payable by the seller or transtèrur at the time of sale.(RCW
8431 NO or RCW 84.31.108).Prior to siwsing (3)below,you may caslach
your local capntv assessar Its’more inksnnatiou.
Tins laud does Q does uibt qualilS for conlinuance.
DEPUTY ASSESSOR DAlE
(2)NOTICE OF(XThIPIAAN(’E(tllSl’ORICPROPERTfl
NEW OWNER(S):To continue special valuation as historic property,
sign (3)below.If the new owner(s)does tiol wish to continue,all
additional tax calculated pursuant to chapter 8426 RCW.shall be due and
payable by Use seller or tratisferor at the lime of sale.
(3)OWNER(S)SIGNATURE
I’RINI’NAME
p-N
This fonu is your receipt
when stamped by cashier.
YES NO
GE
GE
List all personal prnpedv (langible and intangible)included in sellino
price.
None
If claiming an exemption,list WAC number and reason for exemption:
WAC No.(Section/Subsection)WAC458-61A-205(4)
Reason for exemption
Dedication of Street Right of Way
F\pe of Document Deed of Dedication
Dale of Document
_____________________________________________
Gross Selling Price S
Personal Property (deduct)5,
Exemption Claimed (deduct)5,
Taxable Selling Price S
Excise Tax State S
0,0050 Local S
Delinquent Interest:Slate S
Local S
*Dehinqnent Penally S.
Subtotal S
________________________________
5State Technology Fcc
___________________________________
tAffidavit Processing Fee
___________________________________
0cc
oco
0-co
Total Otie
0.00
S 5.00
S 0.00
S 10.OD
A MINIMUM OF 510.00 IS DUE IN FEE(S)AND/ORTAN
tSEE INSTRI 5CTIONS
Q I CER tFY AB EN YOF PEILIU RiTIt ATTHE FOREGOING ISTRI’E ANDCORRECF.
Signalure of SignatLire of
Grantor or Grantor’s Agent Grantee or Grantee’s Agent
Name (print)E-rook Nansc (print)
Dale &city of siroing:Z/Y/fl %tJ%VL’Dale &city of signing:
Perjun:Pcijttn is a class C tëkrny hichs is psutsishable by imprisainicmt its the slate eonvctirsial inshiution for a moxiunusm lcnss oftint mom than five ‘cars.or
a fine iii an amount fixed by the court ofnot mow than live thousand dollars (55.000.00).orbv bohh impdscmrnenl and fine (RCW 9A20.O2OftCfl.
REV $4 000In (09 l4l6)THLS SPACE -TREASURER’S USE ONLY COUNtY TREASURER