StaffReport_SiphonEasements - Laserfiche WebLink

Home Browse Search

Department of Real Estate Excise Tax Affidavit (RCW 82.45 WAC 458-61A) RevenueIVIIIIII Only for sales in a single location code on or after May 1, 2026. Washington State This affidavit will not be accepted unless all areas on all pages are fully and accurately completed. Form 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/Grantor 2 Buyer/Grantee Name Windy City Holdings LLC Name Kittitas County Public Works Mailing address 1410 W. Dolarway Rd., Suite 301 Mailing address 411 N Ruby Street, Suite 1 city/state/zip Ellensburg, WA 98926 city/state/zip Ellensburg, WA 98926 Phone (including area code) 509-899-7371 Phone (including area code) 509-962-7523 3 Send all property tax correspondence to: ❑ Same as Buyer/Grantee Name Windy City Holdings LLC Mailing address 1410 W. Dolarway Rd., Suite 301 City/state/zip Ellensburg, WA 98926 List all real and personal property tax parcel account numbers 962710 Personal Assessed property? value(s) ❑ $194,400.00 ❑ $ 0.00 ❑ $ 0.00 4 street address of propert 2112 Reecer Creek Rd., Ellensburg, WA 98926 This property is located in Kittitas Count (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. _egal description of property (if you need more space, attach a separate sheet to each page of the affidavit). See attached page 5 191 - Undeveloped land (land only) 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 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 transfer involves multiple parcels with different classifications, complete the predominate use calculator (see instructions) ❑Yes 0 No 6 Is this property designated as forest land per RCW 84.33? ❑Yes 0No Is this property classified as current use (open space, farm and agricultural, or timber) land per RCW 84.34? ❑ Yes 0 No Date of document 7 List all personal property (tangible and intangible) included in 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) Reason for exemption Is this property receiving special valuation as historical property per RCW 84.26? ❑ Yes 0 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 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 qualify and will indicate by signing below. If the 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 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: ❑ 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 tax calculated pursuant to RCW 84.26, shall be due and payable by the seller or transferor at the time of sale. (3) NEW OWNER(S) SIGNATURE Type of document Gross selling price 15,000.00 *Personal property (deduct) 0.00 Exemption claimed (deduct) 0.00 Taxable selling price 15,000.00 Excise tax: state Less than $525,000.01 at 1.1% 165.00 From $525,000.01 to $1,52S,000 at 1.28% 0.00 From $1,525,000.01 to $3,025,000 at 2.75% 0.00 Above $3,025,000 at 3% 0.00 Agricultural and timberland at 1.28% 0.00 Total excise tax: state 165.00 0.0050 Local 75.00 *Delinquent interest: state 0.00 Local 0.00 *Delinquent penalty 0.00 Subtotal 240.00 *State technology fee 5.00 Affidavit processing fee 0.00 Signature Print name Signature Print name Total due 245.00 A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX *SEE INSTRUCTIONS