Resolution_QCD Water Rights_DOE - Laserfiche WebLink

Home Browse Search

Department of Real Estate Excise Tax Affidavit (RCW82.45 WAC456-61A) Revenue Only far sales in a single location code on or after July 1, 2022, Washington State This affidavit will not be accepted unless all areas on all pages are fully and accurately completed. ForFtl 84 0001 a 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. 1 Seller/Gmmor Z Buyer/Grantee Name Kittitas County Attn' Board of County Commissioners Name Washington State Department of Ecology Mailing address 205 W 5th Avenue Suite 108 State Trust Water Rights Program City/state/zip EllensburgWA 98926 Mailing address 1250 W Alder Street City/state/zip Union Gap WA 98903 Phone (including area code) 509-962-7508 Phone (including area code) 509-575-2490 3 Send all property tax correspondence to:0 Same as Buyer/Grantee Mailing address 4 street address of propeWater Rights Only/SchneblvR This property is located in Attitas ❑ Check box if any of the listed parcels are being segregated List all real and personal property box Personal Assessed parcel account numbers property? value(s) See attached "Exhibit A" ❑ $ O -N ❑ $ 0.00 ❑ s 0.00 (for unincorporated locations please select your county) rther parcel. are Dart of a boundary line adh:ormnm or arce!s Fe: Legal description of Dropern, (if you need mores ace attach a separate sheet to each page of the affidavit). See Attached 'Exhibit B" Z' EU - Water or Mineral rights 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, 84.3 7, or 84.38 (nonprofit ung., senior citizen or disabled person, homeowner with limited income)? Oyes 0 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:Involves muhiple parnds with dlfFerem clauifiotbns, complete Mepredom1. use cakula[w (see lruanxtbm) ❑Ves ONo 61s this property designated as forest land per RCW 84.33? Ones ONO Is this property classified as current use (open space, farm and agricultural, or timber) land per RCW 84.347 ❑Yes O No Is this property receiving special valuation as historical property per RCW 84.267 ❑ Yes O No 7 List all personal property (tangible and intangible) included in selling price. If claiming an exemption, list WAC number and reason for exemption. WAC number (section/subsection) 458-61A-205 Reason for exemption Per ANcle XI of the Washington State Constiluti0n, the grantor is a governmental entity. Type of document Quit Claim Deed Date of document Gross selling price 0.00 'Personal r It d d If any answers are yes, complete as instructed below. p ape y ( e um) 000 8 1 CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT Signature of grantor or Name (print) - Signature of gramme or agent Name (print) Date & city of signing Date & city of signing Perjury in the secor0 deggrree is a class C felony which is punishable by confinement in a state correctional institution for a maximum term of five rears or by a fne 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 PCW 9A.20.02111)(c)). To ask about the availability ofthis publication in an alternate formft for the vis5ually impaired, please call 360-705-6705. Teletype (TTY) users may use the WA Reay Service by calling 711. REY840001a (3/31/22) THIS SPACE TREASURER'S USE ONLY COUNTY TREASURER Print on legal size paper. Page 1 of 6 (1) NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Exemption claimed )deduct) 000 NEW OWNER(S): To continue the current designation as forest land Taxable selling price 000 or classification as current use (open space, farm and agriculture, or timber) land, you must sign on (3) below. The county assessor must then Excise tax: state determine the land transferred continues to qualify and will indicate Less than $500,000.01 at 1.1% 0.00 by signing below. if the land no longer qualifies or you do not wish to From $500,000.01 to $1,500,000 1.28% 000 continue the designation or classification, it will be removed and the at compensating or additional taxes will be due and payable by the seller From $1,500,000.01 to $3,000,000 at 2.75% 0.00 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 Above $3,000,000 at 3% 0.00 information. Agricultural and timberland at 1.28% 0.00 This land: ❑does ❑ does not quality for Taal excise tax: state 0.00 continuance. 0.0025 Local 0.00 Deputy a.e.orsignature Date 'Delinquent interest: state 0.00 (2) NOTICE OF COMPLIANCE (HISTORIC PROPERTY) Local 0.00 NEW OWNER(S): To continue special valuation as historic property, sign •Delinquent penalty 0.00 (3) below. If the new owners) doesn't wish to continue, all additional tax calculated pursuant to RCW 84.26, shall be due and payable by the seller Subtotal 0.00 or transferor at the time of sale. 'State technology fee 5.00 (3) NEW OWNERS) SIGNATURE Affidavit processing fee 5.00 Signature Signature Total due 10.00 A MINIMUM OF $10.0015 DUE IN FEES) AND/OR TAX Print name Prinaname *SEE INSTRUCTIONS 8 1 CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT Signature of grantor or Name (print) - Signature of gramme or agent Name (print) Date & city of signing Date & city of signing Perjury in the secor0 deggrree is a class C felony which is punishable by confinement in a state correctional institution for a maximum term of five rears or by a fne 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 PCW 9A.20.02111)(c)). To ask about the availability ofthis publication in an alternate formft for the vis5ually impaired, please call 360-705-6705. Teletype (TTY) users may use the WA Reay Service by calling 711. REY840001a (3/31/22) THIS SPACE TREASURER'S USE ONLY COUNTY TREASURER Print on legal size paper. Page 1 of 6