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HomeMy WebLinkAbout95021000640 R IGINAL $7. D0 CliCK FILED-BY: BRE~ERTON CITY CLERK Filed for Record at Request of: KAREN FLYNN, AUOITOR CL£RK: When Recorded Return to: ~ame Bre~erto~ City Clerk ~ddre$~ 239 Fourth Bre,~erton. Wa~hinc~to~ 983~.0 ~UIT CLAIM BEE~ (For Use in the State of Waehtngto~ Only) therein uhich Grantors my hereafter ac~ire: P~ovi~, That if the ~ve pretty she[[ cease to ~ held or m~ for ~ki, recreatim or ~ s~ce, the OATEO this /~ ~y of ~ff3/~,~ , 1'~. i~ivi~[m ~r{~ in ~ ~o ex~ut~ the within ~ for~t~ imtr~t, ~ ~k~t~g~ that th~ li~ the sm as their fr~ ~ vot~tary ~t ~ ~, f~s ~ ~r~ therein ~ti~. R[.~N Nr ~ h~ ~ official sea[ thiA~y of / [ Washl~t~ r { ~%~ ~ ~ W~ TRANSACTI~ EXCI~E T~ PAID F~ ~ 0 ~ QUIT C~IM DEED AM~NT~ ~s~.~m - ,e,t E,~,,, Di~. - ,/~/~ COUN~URER © LEASE TYPE OR PRINT REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt when stamped LEASE SEE REVERSE by cashier. Form No. 84 CHAPTER $2.45 RCW - CHAPTER 458-61 WAC For Use at County Treasurer's Office (Use Form No. 84-0001B for R~porting Transfers of Controlling Interest of Entity Ownership to the Department of R~venue) THIS AFFIDAVIT V41LL NOT BE ACCEl'TED UNLESS ALL AREAS 1--7 ARE FULLY COMPLEYEO m Name KOBERT L, HUSSliAN ~ Name CITY OF BR.I~ERTON i 53/*-,1 Juniper Street 239 ~'ourth Street Street Street Brewer ton, ~IA. q g 310 Breamr ton, WA. 98337 City State Zip City State Zip l[] ADDRESS TO SEND ALL PROPERTY TAX RELATED CORRESPONDENCE ALL TAX PARCEL NUMBERS lame City o~ Bre~rton ~ · :::.::i:::.:::.:::.::~:: ~!~ii:.~::~i~?:~::~::~::~::~::~::~:?:~::~::~::~::~ 239 ~ourth ~treet 3965-000-132-0107 :ity/State Bremerto~, 'YesMn~ton Zip 9,q3~7 :.~!?.~:.~:.~:.~:.?.~:.~:.~:.~!~:.~:j:.~!~:.~:.~:.~:.~:.~:.~:.~:.~:.~:.~:.~:.~:.~:.~:?~:~!~:~:.~:.~:~:~*?! ~r~rton ~l LEGAL DESCRIPTION OF PROPEI~Y SITUATED IN [] UNINCORPORATED COUNTY ~:q OR IN CITY OF ~ 534--`1 J~iper 5tree~ ;~eet Address (if prope~y is hnprovcd)~ Please aec attached Exhibit ills this property currently: YES NO IIDescription of tangible personal property if included in sale (furniture, Classified or designated as forest lan~? [] [] appliances, etc.) Chapter 84.33 RCW Classified as current use land (open space, farm [] [] and agricultural, or thnber)? Chapter 84.34 RCW .~-, Exempt from property tax as a nonprofit [] [] If exemption claimed, list WAC number and explanation. organization? Chapter 84.36 RCW WAC t~58-61-~I0 Seller's Exempt Reg. No. WAC No. {Sec/Sub) ~or and in consideration Receiving special valuation as historic [] [] Explanation property under?. Chapter 84.25 RCW public donation and ~x~t, fli~operty Type: ~ land only [] land with new building Outt Claim Deed [] land with previously used building [] land with mobile home Type of Document [] timber only [] building only Principal Use: [] Apt. (4 + unit) [] residential ~timber ]~a~alCo~t []commercial/industrial Gross Sale Price $ other Pemonal Property (deduct) $ Taxable Sale Price $ -0- l~l (1) NOTICE OF CONTINUANCE (RCW 84.33 or RCW 84.34) Excise Tax State $ If the new owner(s) of land that is classified or designated as current use Local $ or forest land wish to continue the classification or designation of such -0- 1and, the new owner(s) must sign below. If the new owner(s) do not desire Delinquent Interest: State $ -0 to continue such classification or designation, ali compensating or additional Local $ tax calculated pursuant to RCW 84.33.120 and 140 or RCW 84.34.108 shall -0- be due and payable by the seller or transferor at the time of sale. The county Delinquent Penalty: State $ assessor must determine if the land transferred qualifies to continue Total Due $ -0- ;.~c, classification or designation and must so indicate below. Signatures do THERE IS A $21}0 FEE FOR PROCESSING THIS FORM IF NO TAX IS ~ not necessarily mean the land will remain in classification or designation. If it no longer qualifies, it will be removed and the compensating taxes [] AFFIDAVIT will be applied. All new owners must sign. I certify under penalty of perjury under the laws of the This land [] does [] does not qualify for continuance. Washington that the foregoing is true and correct. Date Signature of / DEPUTY ASSESSOR Grantor/Agnnt ROBERT L. MUSSI4AN (2) NOTICE OF COMPLIANCE (Chapter 84.26 RCW) Name (print) , [~ If the new owner(s) of property with special valuation as historic property wish to continue this special valuation the new owner(s) must sign below. Date & Place of Signing bremercon, ~/A, If the new owner(s) do not desire to continue such special valuation, all additional tax calculated pursuant to Chapter 84.26 RCW, shall be due Signature of and payable by the seller or transferor at the time of sale. Grantee/Agent lan R. Sievero, Cit:y (3) OI~rNER(S) $IGNATUR~ Name (print) Date & Place of Signing ;~,-~,~..-~,.,, ua ' i PERJURY: Perjury is a class C felony which is punishable by imprisonment in a state correctional institution for a maximu~ term of not more than five years, or by a fine in an amount fixed by the court of not more than five thousand dollars ($5 000 or by both imprisonment and fine (RCW 9A.20.020 (lC)). FOR TREASURER'S USE ONLY ., TAXPAYER FORM REV 84 000lA (12-93) (PD 12-17-93) EXHIBIT u~,, That portion of Lot 132, First Addition to Sheridan Park, as recorded in Vol. 8, page 23, of Plats in Kitsap County Washington described as follows: Beginning at the most northwesterly corner of said Lot 132; thence S42"39'47"W 30 feet to the True Point of Beginning; thence N42"39'47"E 30 feet; thence S47"20'13"E 29 feet; thence southwesterly along a straight line to the True Point of Beginning.