HomeMy WebLinkAboutREETA201611021i Check box it’anv 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 (il more apace is needed,you may attach a separate sheet to each page of the at’fidavit)
The southerly and westerly 4 feet of the following described parcel:
Tract A and C,Block 5,Renton Highlands No.2,Corrected Plat recorded in Volume 57 of Plats,Pages 92 to 93,inclusive,records of
King County,Washington,LESS that portion lying Easterly of a line beginning at the Northwest corner of Tract B of said p1st;thence
North 04”41 ‘00”East to the Northerly line of Tract C.
Select Land Use Code(s):
ghway and street right of way
enter any additional codes:______________________________________
(See back of last page f’or instructions)
YES NO
Was the seller receiving a property tax exemption or deferral under Q
chapters 84.36.84.37.or $4.38 RCW (nonprofitorganization,senior
citizen,or disabled person,homeowner with limited income)?
Is this property designated as forest land per chapter 84.33 RCW?
Is this property classified as cuntnt use (open space.farm and
agricultural.or timber)land per chapter 84.34 RUW?
Is this property receiving special valuation as historical property
per chapter84.26 RCW?
Ifany answers are yes,complete as instructed below.
(1)NOTICE OF CONTINUANCE (FOREST LAND OR CURRENT t (SE)
NEW OWNER(S):To continue the ctrrrent 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 qualiI)and will indicate by signing below.If thc
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 ofsale.(RCW
84.33.I4()orRCW 84.34.108).Pijorto signing (3)below,you max’contact
votir local cotinty assessor for more information.
This land Q does does not qualif’t’or continuance.
List all personal property (tangible and intangible)included in selling
price.
Right of Way improvements on Harrington Ave NE,Index Ave NE,and NE
16th Street.Including new curb,gutter,and sidewalk.As well as street
lights,and storm water infrastructure.Also included are new public water
mains,hydrants,and appurtenances.
If claiming an exemption.list WAC number and reason for exemption:
WAC No.(Section/Subsection)458-61 A-205
Reason for exemption
Transfer from governmental entity to another governmental entity
S 0.00
$
$
S 0.00
$0.00
5 0.00
S
S
A MINIMUM OF $10.00 IS DUE IN FEE(S)AND/OR TAX
*SEE INSTRUCTIONS
Department ofRevenue
Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt
PLEASE TYPE OR PRINT CHAPTER $2.45 RCW —CHAPTER 458-61 A WAC when stamped by cashier.
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED
(See hack of last page for instructions)0 Check box if partial sale ofpropertv If multiple owners,list percentage of ownership next to name.I Name Renton School District No.403.a Municinal I Name City of Renton,a Municiøal corporation
rnrpnratinn
Mailing Address 300 SW 7th Street Mailing Address 1055 S.Grady Way
City/State/Zip Renton WA 98057 City/State/Zip Renton WA 98057
Phone No (including area code)(425)204-2300 Phone No tineluding area code)(425)430-6400
U List all real and personal property tax parcel accountSendallpropertytaxcorrespondenceto:I Same as Buyer/Grantee .List assessed value(s)numbers—check box ifpersonal property
Name Ptn 722780-0135 Q Not Applicable
Mailing Address Ti
City/State/Zip ri
‘hone No (including area code)________________________________________J1
Street address of property.1800 Index Avenue,Renton WA 98046
This property is located in Renton
YES NO
00
00
Type of Document Deed of Dedication
Date of Document
______________
Gross Selling Price
*Personal Property (deduct)
Exemption Claimed (deduct)
Taxable Selling Price
Excise Tax :State
I 0.0050 Local
*Delinquent Interest:State
Local
*Delinquent Penalty S.
DEPUTY ASSESSOR DATE
(2)NOTICE OF COMPLIANCE (HISTORIC PROPERTY)
NEW OWNER(S):To continue special valuation as historic property.
sign (3)below.If the new ow’ner(s)does not wish to continue,all
additional tax calculated pursuant to chapter 84.26 Rt’W.shall he due and
payable by the seller or transferor at the time of sale.
(3)OVNER(S)SIGNATURE
PRINT NAME
Subtotal $
-.
0.00
*State Technology Fee $5.00
*Aftldavit Processing Fee S 5.00
Total Due $10.00
U I CERT INDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Grantor or Grantor’s Agent
Signature ofSignatureof
Grantee or Grantee’s Agent
Name (print)Name (print)
Date &city of signing:I i I )“Date &city of signing:
I’erjury:Perjury is a class C felony which is punishable by imprisonment in the state correctional institution for a maximum term ofnot more than five years.or by
a tine in an amount fixed by the court ofnot more than five thousand dollars ($5,000.00).or by both impiisonrnent and fine (RCW 9A.2t).020 (1 C)).
REV 840001 a (01/04/16)IT 1S SPACE -TREASURER’S USE ONLY COUNTY TREASURER