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Real Estate Excise Tax Affidavit (RCW 82.45 WAC 458-61A)
Only for sales in a single location code on or after January 1, 2020.This affidavit will 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.
Check box if partial sale, indicate % sold.List percentage of ownership acquired next to each name.
2 Buyer/Grantee
Name
Mailing address
City/state/zip
Phone (including area code)
1 Seller/Grantor
Name
Mailing address
City/state/zip
Phone (including area code)
3 Send all property tax correspondence to: Same as Buyer/Grantee
Name
Mailing address
City/state/zip
List all real and personal property tax parcel account numbers Personal property?Assessed value(s)
4 Street address of property This property is located in (for unincorporated locations please select your county)
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 space, attach a separate sheet to each page of the affidavit).
5
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)? Yes 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 No
6 Is this pr operty designated as forest land per RCW 84.33?Yes No
Is this property classified as current use (open space, farmand agricultural, or timber) land per RCW 84.34? Yes No
Is this property receiving special valuation as historical property per RCW 84.26? Yes No
If 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 landor classification as current use (open space, farm and agriculture, ortimber) land, you must sign on (3) below. The county assessor must thendetermine if the land transferred continues to qualify and will indicateby signing below. If the land no longer qualifies or you do not wish tocontinue the designation or classification, it will be removed and thecompensating or additional taxes will be due and payable by the selleror transferor at the time of sale (RCW 84.33.140 or 84.34.108). Prior tosigning (3) below, you may contact your local county assessor for moreinformation.
This land: does does not qualify for continuance.
____________________________________ ____________________ Deputy assessor signature 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 taxcalculated pursuant to RCW 84.26, shall be due and payable by the selleror transferor at the time of sale.
(3) NEW OWNER(S) SIGNATURE____________________________ _________________________Signature Signature____________________________ _________________________Print name Print name8 I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT
Signature of grantor or agent _______________________________ Signature of grantee or agent __________________________
Name (print) Name (print)
Date & city of signing 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 of five years, 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.20.021(1)(c)).
REV 84 0001a (9/17/21)THIS SPACE TREASURER’S USE ONLY COUNTY TREASURER
7 List all personal property (tangible and intangible) included in sellingprice.
If claiming an exemption, list WAC number and reason for exemption.
WAC number (section/subsection)
Reason for exemption
Type of document
Date of document
Gross selling price
*Personal property (deduct)
Exemption claimed (deduct)
Taxable selling price
Excise tax: state
Less than $500,000.01 at 1.1%
From $500,000.01 to $1,500,000 at 1.28%
From $1,500,000.01 to $3,000,000 at 2.75%
Above $3,000,000 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 MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX*SEE INSTRUCTIONS
To ask about the availability of this publication in an alternate format for the visually impaired, please call 360-705-6705. Teletype (TTY) users may use the WA Relay Service by calling 711.
Form 84 0001a
THE NORTH 1.50 FEET OF LOT 26 IN BLOCK 46, CORRECTED PLAT RENTON HIGHLANDS
NO. 2, RENTON-WASHINGTON, ACCORDING TO THE PLAT THEREOF, RECORDED IN
VOLUME 57 OF PLATS, PAGES 92 THROUGH 98, IN KING COUNTY, WASHINGTON;
TOGETHER WITH THAT PORTION OF LOT 25 OF SAID BLOCK 46 DESCRIBED AS FOLLOWS:
BEGINNING AT THE SOUTHWEST CORNER OF SAID LOT 25;
THENCE NORTH 03°36'45" EAST ALONG THE WEST LINE THEREOF 7.51 FEET;
THENCE SOUTH 88°58'27" EAST 106.08 FEET;
THENCE NORTH 48°14'26" EAST 2.70 FEET;
THENCE SOUTH 88°57'04" EAST 10.33 FEET;
THENCE SOUTH 46°09'16" EAST 2.69 FEET;
THENCE SOUTH 88°58'27" EAST 14.64 FEET TO THE EAST LINE OF SAID LOT 25;
THENCE SOUTH 03°36'45" WEST ALONG SAID EAST LINE 7.51 FEET TO THE SOUTHEAST
CORNER OF SAID LOT 25;
THENCE NORTH 88°58'27" WEST ALONG THE SOUTH LINE OF SAID LOT 25 A DISTANCE OF
135.00 FEET TO THE POINT OF BEGINNING;
SAID PORTIONS CONTAINING APPROXIMATELY 1163 SQUARE FEET.
Legal Description