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HomeMy WebLinkAboutsigned REETA form - 8.5x11.pdfDepartmentofRevenueWashingtonStateREALESTATEEXCISETAXAFFIDAVITThisformisyourreceiptPLEASETYPEORPRINTCHAPTER82.45RCW—CHAPTER458-61AWACwhenstampedbycashier.THISAFFIDAVITWILLNOTBEACCEPTEDUNLESSALLAREASONALLPAGESAREFULLYCOMPLETED(Seebackoflastpageforinstructions)riCheck’0_.__I-‘‘—“—“-‘7,,sntd.ListnercentaneofnwnershtnarorrirednexttocactinamaINameMGP47LLCc/pMerrillGardensINoneCityofRenton,aMunicipalCorporationMaitingAddress1938FairviewAveE.Suite300MailingAddress1055SouthGradyWayCity/State/ZipSeattle.Wa.98102City/State/ZipRenton,WA98057PhoneNo.(includingareacode)(206)676-5300—PhoneNo.(inctudingareacode)J425,)430-6400GListattrealandpersonatpropertytaxparcetaccoantSendaltproperlytaxcorrespondenceto:a’SameasBayer/GranteeListassessedvalue(s)numbers—checkboxifpersonalproperlyNamePortionofoarcel#7231502030MaitingAddressPortionofparnel#721502120ElCity/State/ZipElPhoneNo.(inctudingareacode)________________________________________El•Streetaddressofproperty:104BurnettAveS(parcel#7231502030);noaddressassignedtoparcel#7231502120ThispropertyislocatedinRentonElCheckboxifanyofthetistedparcetsarebeingsegregatedfromanotherparcel,arepartofaboundarytineadjostmentorparcelsbeingmerged.Legatdescriptionofproperty(ifmorespaceisneeded,youmayattachaseparatesheettoeachpageoftheaffidavit)FulllegalonExhibitAattachedhereto.Abbreviatedproperlydescription:THEEASTERLY2.25FEETOFLOTS16,17ANDAPORTIONOFLOT18,BLOCK24,TOWNOFRENTON,ACCORDINGTOTHEPLATTHEREOFRECORDEDINVOLUMEIOFPLATS,PAGE135,INKINGCOUNTY,WASHINGTON.SelectLandUseCode(s):Listallpersonalproperty(tangibleandintangible)includedinselling45-HighwayandstreetrightofwayIprice.crateranyadditionalcodes:___________________________________None(Seebackoflastpageforinstructions)YESNOWasiltesellerreceivingaproperlytaxexempdottordeferralunderElchapters8436,84.37,or84.38RCW(nonprofitorganization,seniorcitizen,ordisabledperson,ltorneossiaersvitlttitnitedincome)?UIfclaiminganexemptiont.listWACnumberandreasotsforexemption:YESNOIsthisproperlydesignatedasforestlandperchapter84,33RCW?El0WACNo.(Section/Subsection)458-61A-205(4)Isthispioperlyclassifiedascurrentuse(openspace.fanntandEl0..Reasonforexemptionagricultural,orlumber)landperchapter84.34RCW?DedicationofStreetRightofWayIsthisproperlyreceivingspecialvaluatiotrasItistoricalpropertyEl0perchapter84.26RCW?Ifanyanswersareyes,completeasrnsthactedbelow.TypeofDocumentDeedofDedication(1)NOTICEOFCONTINUANCE(FORESTLANDORCURRENTUSE)NEWOWNER(S):TocontinuethecurrentdesignationasforestlandorDateofDocuiarent11/30/18classificationascurrentuse(openspace.farmandagriculture,ortimber)land,youmustsignon(3)below,lirecountyassessornnustthendetermineiftheGrossSellnngPrice$______________________________________landtmrssferredcontinuestoqualittyandwillindicatebysigningbelow.Iftise5PersonalProperty(deduct)S_________________________________landnolongerqualifiesoryoudotsotsvislrtocontinuetiredesignationor........ExemptionClaimed(deduct)$_________________________________classification,itwillberemovedandtimecotnpensatingoradditionaltaxeswillbedaeandpayablebythesellerortransferorattiredineofsale.(RCWTaxableSellingPrice$0.0084.33.140orRCW84.34.108).Priortosigniitg(3)below’,youmaycontactExciseTax:State$0.00yourlocalcountyassessorformoreinformation.I0.0050Local$0.00ThislandEdoesEldoesnotqualifyforcontinuance.tDelinquentInterest’State$___________________________________Local$_________________________________DEPUTYASSESSORDATE5DeltnquentPenalty$_________________________________(2)NOTICEOFCOMPLIANCE(HISTORICPROPERTY)NEWOWNER(S):TocontimsuespecialvaluationasIsistoricproperty,Subtotal$0.00sign(3)below.Iftirenesvosvner(s)doesnotsvishtocontinue,all5StateTechnologyFee$5.00additioaaltaxcalculatedpursuanttochapter84.26RCW,smallbedueandpayablebythesellerortransferoratthetimeofsale.nAffidavitProcessingFee$___________________________________(3)OWNER(S)SIGNATURETotalDue$10.00PRINTNAMEAMINIMUMOF810.00ISDUEINFEE(S)AND/ORTAX°SEEINSTRUCTIONSDaICERTIFYUNDPELTYPERJURYThATTHEFOREGOINGISTRUEANDCORRECT.SignatureofSignatureofGrantororGrantor’sAgentGrmtntecorGrantee’sAgentName(pnnt)VICOName(priist)Date&cityofsigning:(‘/1Ie’fDate&cityofsigrsing:Perjury:PerjuryisaclassCfelorsysvltichispunishablebyiinprisotsitsentinUsestalecorrectiotsaliirsiimtionforainaxirsrursrtennofnotmoretItanfiveyears,orbyaflueitsanamountfixedbytirecourtofnotmoretitanfivethousanddollars($5,000.00),orbybothimprisonmentandfitse(RCW9A.20.020(IC)).REV84000ta(09/06/t7)THISSPACE-TREASURER’SUSEONLYCOUNTYTREASURER ExhibitALegalDescriptionProject:wonPID723150-2030/723150-2120GRANTOR:MPG47,LLC,Street:WilliamsAveS.WILLIAMSAVENUESDEDICATIONTHEEASTERLY2.25FEETOFLOTS16AND17,BLOCK24,TOWNOFRENTON,ACCORDINGTOTHEPLATTHEREOFRECORDEDINVOLUME1OFPLATS,PAGE135,INKINGCOUNTY,WASHINGTON;ANDTHEEASTERLY2.25FEETOFLOT18,BLOCK24,TOWNOFRENTON,ACCORDINGTOTHEPLATTHEREOFRECORDEDINVOLUME1OFPLATS,PAGE135,INKINGCOUNTY,WASHINGTON;EXCEPTTHENORTH20FEETOFSAIDLOT18CONVEYEDTOTHECITYOFRENTONBYDEEDRECORDEDUNDERRECORDINGNO.20080425000371.CONTAINING293SQUAREFEET,MOREORLESS.SITUATEINTHECITYOFRENTON,KINGCOUNTY,WASHINGTON./DEEDofDEDCATIONdoc\SMTPage3of4FORM040001/bh