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Department “(@a Real Estate Excise Tax Affidavit (Row 82.45 wac 458-614)Revenue
Washington State Only for sales in a single location code on or after April 1,2025.This affidavit will not be accepted unlessall areas on all pages arefully and accurately completed.Form 84 0001a This form is your receipt when stampedby cashier.Please type orprint.
RX)check boxif partialsale,indicate%__5.9 sold.
1 Seller/Grantor
Name _Gagik Nazaryan &Lusine Gharibyan
List percentage of ownership acquired next to each name.
2 Buyer/Grantee
Name ___City of Renton
Mailing address _2214 Duvall Avenue NE
City/state/zip Renton,Washington 98059
Phone(including area code)425-227-6997
3 Send all property tax correspondenceto:4 Sameas Buyer/Grantee
Name
Mailing address
City/state/zip
4 Street address of property.2120 Duvall Avenue NE
This propertyis located in Renton
Mailing address__1055 South Grady Way
City/state/zip Renton,Washington 98057
Phone(including area code)
List all real and personal property tax Personal Assessed
parcel account numbers property?value(s)
032305-9240 Xi $638,000
O
(for unincorporated locationsplease select your county)
Checkboxif any of the listed parcels are being segregated from anotherparcel,are part of a boundaryline adjustmentor parcels being merged.
Legal description of property (if you need morespace,attach a separate sheet to each page oftheaffidavit).PTN OF N 1/2,S1/2,SE1/4,NW 1/4,SECTION 3,TWP 23 N -,RG 5 E.,W.M.IN KING COUNTY,WASHINGTONFULLLEGALDESCRIPTIONSHOWNONATTACHEDEXHIBITA
BS Landusecode 45 -Highway &street right-of-way
Enter any additional codes
(see backof last page for instructions)
Wastheseller receiving a property tax exemption or deferralunderRCW84.36,84.37,or 84.38 (nonprofit org.,seniorcitizenordisabledperson,homeownerwith limited income)?Oves {no
Isthis property predominately usedfor timber(asclassified
under RCW 84.34 and 84.33)oragriculture (as classified under
RCW84.34.020)and will continuein it’s current use?Ifyes and
the transfer involves multiple parcels with different classifications,
complete the predominateuse calculator(see instructions)[]yes x No
7 List all personalproperty (tangible and intangible)includedin selling
price.
If claiming an exemption,enter exemption code and reason for
exemption.*See dor.wa.gov/REET for exemption codes*
Exemption No.(sec/sub)458-61A-205(4)
Reason for exemptionDEDICATIONOFSTREET RIGHT-OF-WAY
6 Is this property designatedas forest land per RCW 84.33?[1]Yes No
Is this propertyclassified as current use (open space,farm
and agricultural,or timber)land per RCW 84.34?Oo Yes IX No
Is this property receiving special valuationashistorical
property per RCW 84.26?Oves X No
lf any answers are yes,complete as instructed below.
(1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENTUSE)
NEW OWNER(S):To continue the current designationas forest land
orclassification as current use (open space,farm andagriculture,or
timber)land,you must sign on (3)below.The county assessor must then
determineifthe 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 designationorclassification,it will be removed and the
compensatingoradditional taxes will be due and payable bytheseller
ortransferorat the time of sale (RCW 84.33.140 or 84.34.108).Prior to
signing (3)below,you may contact yourlocal county assessor for more
information.
This land:O does DO doesnot qualify for
continuance.
Deputy assessorsignature 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 additionaltaxcalculatedpursuanttoRCW84.26,shall be due and payable bythe seller
or transferorat the timeofsale.
(3)NEW OWNER(S)SIGNATURE
Signature Signature
Print name Print name
Type of document ___DEED OF DEDICATION
Date of document 8/06/2025
Grossselling price
*Personal property (deduct)
Exemption claimed (deduct)
Taxableselling price
Excise tax:state
Less than $525,000.01 at 1.1%
From $525,000.01 to $1,525,000at 1.28%
From $1,525,000.01 to $3,025,000at 2.75%
Above $3,025,000 at 3%
Agricultural and timberland at 1.28%
Total excise tax:state
Local
*Delinquent interest:state
Local
*Delinquent penalty
Subtotal
*State technology fee
Affidavit processing fee
Total due
A MINIMUMOF$10.00 IS DUE IN FEE(S)AND/OR TAX*SEE INSTRUCTIONS
8 |CERTIFY UNDER PENALTY OF PERJURY THAT THE FO EGOINGIS TRUE
Signature of grantor or agent
Name(print),hh YS INE CS LB YAN
Date &city of signing (of15]QF Read on
AND CORRECT
Signature of grantee or agent
;Name(print).
Date &city of signing
Perjury in the second degreeis a class Cfelony which is punishable by confinementin a state correctionalinstitution for a maximum termoffive years,orbyafineinanamountfixedbythecourtofnotmorethan$10,000,or by both such confinementandfine (RCW 9A.72.030 and RCW 9A.20.021(1)(c)).
To ask abouttheavailability of this publication in an alternate formatfor the visually impaired,please call 360-705-6705.Teletype(TTY)users may use the WARelayService bycalling 711.
REV 84 0001a ((3/17/25)THIS SPACE TREASURER’S USE ONLY COUNTY TREASURER
Print onlegalsize paper.
Page lof6
Department “(¢a Real Estate Excise Tax Affidavit (Row 82.45 wac458-61)RevenueWashington State Only forsales in a single location cod
Xl Check boxif partial sale,indicate %5.9 sold.
1 Seller/Grantor
Name Gagik Nazaryan &Lusine Gharibyan
eon or after April 1,2025.as nn’This affidavit will not be accepted unlessall areas onall pagesare fully and accurately completed.orm 84 0001a This form is your receipt when stampedby cashier.Please typeorprint.
List percentage of ownership acquired next to each name.
2 Buyer/Grantee
Name City of Renton
Mailing address 2214 Duvall Avenue NE
City/state/zip Renton,Washington 98059
Phone(including area code)425-227-6997
3 send all property tax correspondenceto:&Same as Buyer/Grantee
Name
Mailing address
City/state/zip
4 Street addressof property 2120 Duvall Avenue NE
This propertyis located in Renton
Mailing address 1055 South Grady Way
City/state/zip Renton,Washington 98057
Phone(including area code)
List all real and personal property tax Personal Assessedparcelaccountnumbersproperty?value(s)032305-9240 &$638,000
(for unincorparated tk
ions please select your county) Checkboxif any of the listed parcels are being segregated from another parcel,are part of a boundaryline adjustmentor parcels being merged.
Legal description of property (if you need more space,attach a separate sheet to each pageofthe affidavit).
PTN OF N 1/2,S1/2,SE1/4,NW 1/4,SECTION 3,TWP 23 N.
FULL LEGAL DESCRIPTION SHOWN ON ATTACHED EXHIBIT
_RGSE.,W.M.IN KING COUNTY,WASHINGTONA
5 Landuse code 45 -Highway &street right-of-way
Enter any additional codes
(see back of last page for instructions)
Wastheseller receiving a property tax exemptionor deferralunderRCW84,36,84.37,or 84.38 (nonprofit org.,seniorcitizenordisabledperson,homeowner with limited income)?O yesPX No
Is this property predominately used for timber(asclassified
under RCW 84.34 and 84.33)or agriculture (as classified under
RCW 84.34.020)and will continuein it’s current use?Ifyes andthetransferinvolvesmultipleparcelswithdifferentclassifications,
complete the predominateuse calculator(see instructions):[[]yes ix No
7 List all personal property (tangible and intangible)includedin selling
price.
If claiming an exemption,enter exemption code and reason for
exemption.“See dor.wa.gov/REET for exemption codes*
Exemption No.(sec/sub)458-61A-205(4)
Reasonfor exemptionDEDICATIONOF STREET RIGHT-OF-WAY
6 Is this property designated as forest land per RCW 84.33?L1 Yes No
Is this property classified as current use (open space,farm
and agricultural,or timber)land per RCW 84.34?Oves RX{No
Is this property receiving special valuation as historicalpropertyperRCW84.26?Dves Rl No
lf any answersare yes,completeas instructed below.
(1)NOTICE OF CONTINUANCE (FOREST LAND OR CURRENTUSE)
NEW OWNER(S):To continue the current designation as forest land
or classification as current use (open space,farm and agricuiture,or
timber)land,you mustsign on (3)below.The county assessor must then
determineif 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 designationorclassification,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:O does O does not qualify for
continuance.
Deputy assessorsignature 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 bytheseller
or transferor at the time of sale.
(3)NEW OWNER(S)SIGNATURE
Signature Signature
Print name Print name
Type of document DEED OF DEDICATION
Date of document 8/06/2025
Grossselling price
*Personal property (deduct)
Exemption claimed (deduct)
Taxable selling price
Excise tax:state
Less than $525,000.01 at 1.1%
From $525,000.01 to $1,525,000 at 1.28%
From $1,525,000.01 to $3,025,000 at 2.75%
Above $3,025,000 at 3%
Agricultural and timberland at 1.28%
Total excise tax:state
Local
*Delinquentinterest:state
Local
*Delinquent penalty
Subtotal
*State technology fee
Affidavit processing fee
Total due
A MINIMUM OF $10.00 IS DUE IN FEE(S)AND/OR TAX
*SEE INSTRUCTIONS
8 |CERTIFY UNDER PENALTY OF PERJU THE FOREGOING IS TRUE AND CORRECT
Signature of grantor or agent Signature of grantee or agent
Name(tint)Lu S INE CHM 2f VAN Name(print)
Date &city of signing 19[15]<2 S-Kent Oh
Date &city of signing
Perjury in the second coerce is a class C felony which is punishable by confinementin a state correctionalinstitution for a maximum term offive years,orbyafineinanamountxedbythecourtofnotmorethan$10,000,or by both such confinementandfine (RCW 9A.72.030 and RCW 9A.20.021(1)(c)).
To ask abouttheavailability of this PHblication in an alternate fone for the visually impaired,please call 360-705-6705.TeletypeY)users may use theWA Re!
REV 84 0001a (3/17/25)THIS SPACE T'
ay Service by calling 711.
REASURER’S USE ONLY COUNTY ASSESSOR
vi size euper
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