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Home My WebLink About3215683 I. I" CTY J: lRE 1E ~.uN I DEEr $:.9 3215683 P<lge 1 of 2 18/22/199984\2P Ki\s<lp Co, WR . Filed for Record at Request of: When Recorded Return to: Name Bremerton City Clerk Address 239 Fourth Street Bremerton, WA. 98337 Document Title: Statutory Warranty Deed Reference Number of Document Assigned or Released: Not Applicable Grantor's Name: Susan J. Matan Grantee's Name: City of Bremerton Abbreviated Legal Description: Tract A, First Addition to Anderson Cove, according to plat recorded in Volume 7 of Plats, page 68, records of Kitsap County, Washington Assessor's Property Tax Parcel/Account Number: 3703-006~OOl-0000 STATUTORY WARRANTY DEED (For Use in the State of Washington Only) THE GRANTOR, Susan J. Matan, and in consideration of good and valuable consideration, conveys and warrants to the CITY BREMERTON, the following described real estate, situated in the County of Kitsap, State of Washington: Abbreviated Legal Description: Tract A, First Addition to Anderson Cove, according to plat recorded in Volume 7 of Plats, page 68, records of Kitsap County, Washington DATED this Iff)... fl9. , 19~ STATE OF WASHINGTON COUNTY OF tlls..o.p ss. STATUTORY WARRANTY DEED LYNCH.SWD - 10/23/98 On this date, before me, the undersigned, a Notary Public in and for the State of Washington, duly conunissioned and sworn, personally appeared Susan J. Matan, to me know to be the individual described in and who executed the within and foregoing instrument, and acknowledged that she signed the same as her free and voluntary act and deed, for the uses and purposes therein mentioned. GIVEN under OCd;r0u. my hand and official , 19~ Q9 seal this I~ day of """"" ", " ,'(j ", <> . ,. -'.,:,', / ".' -. u "'" ,~. My appointment expires: Iv) JIJ/91Mi',<, ( ( ": "~ :, ~/' I, I ,II l TY :' BREME I 'ur I I, I I, DEI ,I $8. 'B 3215683 Page 2 of 2 lB!22!1999B4'12P Kitsap Co, ~A STATUTORY WARRANTY DEED LYNCH.SWD - 10123/98 1 pLEASE TYPE OR PRINT PLEASE SEll REVERSE REAL ESTATE EXCISE TAX AFFIDAVIT Form No. 84 OOOlA CHAPTER 82,45 RCW- CHAP'JER 458-61 WAC For Use at County Treasurer's Office (Use Form No. 8~1B for Reporting Transfers of Controllin8 Interest of Entity Ownership to the Department of Revenue) THIS AFFIIlAVIT WILL N(JI' BE ACCEPTED UNLESS ALL AREAS 1-7 ARE FULLY COMPLEfED This them is yoor receipt when stamped by cashier, ,'::., I.' <;i" I'i .... , il>~ t"i-:irc Name City/State fyo"V/i ,),', i.hA Zip J /;, i 7 II LEGAL DESCRIPTION OF PROPERfY SITUATED IN 0 UNINCORPORATED Street Address (if property is improved): ruT A fiST /\li,t-,,,,\ , . a Name !:lOll d Street l'.I.:lCl City i ,iJ i <k J State (, iH Zip~~~"';70 . ADDRESS TO SEND ALL PROP~ TAX RELATED CORRESPONDENCE Name ':"/ . f',(.l m.i.'~/1 _ . " "-:;, { , l, t. Street ,::.; ~ L1 d;.J { h ..sf, QJ?'1 ~ 3'} ,.J. [: .._,'1 ~t):, lie p{'JJ'; , B ~!:l =~ I-q / "r"> ,,'~ /{ ry,J yr.e'I"Ic.,'i'l .c[r . I , -.J <-,+( ~n'r -, ir ~f Street " City ,)('> Y'f!e ( tvl\ ALL TAX PARCEL NUMBERS Stateu.J1l Zip';' l:! j 7 -__.1 ~~lIi.I]IIII~:iil it.i~!iiii':,; ..,,4-.........-.. =:. ~;::::::~?~::!:ir?:~:~::::: ::::~::::::.:::(:i:~:::i:::~::?:::::~?:::::::~:!:~ ''')'70''',- ,)C'b-CL - I..~ c; '... U COUNTY ~ OR IN CITY OF &I'W"'I '" r l\ i r\v\I.\;-" ,,' ~.; (,.r' (' c.. ( , -I L,i..\ '; I ~. ~l ) \I 1'0_' , i \\." IV " I c' t , , . , " , '\(.1 ' . "':", v,...., \ "'1 ) j 4u \\<:1 ..~ C<' ( , l, '0, '" \.> ~ {{\ II Is this property currently: NO III Description of tangible personal property if included in sale (furniture, appliances, ele,) Principal Use: 0 Apt. (4 + unit) 0 residential D.. ti~r . 0 agricult~l. _ ' 0 commercial/industrial Gross Sale Price -KJ other N " ,) "'::::::j r t\( , \ ,~ Personal Property (deduct) . (I) N(JI'ICE OF CONTINUANCE (RCW 84,33 or RCW 84.34) Taxable Sale Price Excise Tax State If the new owner(s) of land that is classified or designated as current use or forest land wish to continue the classification or designation of such Local land, the new owner(s) must sign below. If the new owner(s) do not desire , J?elinquent Interest: State ~ continue such classification or designation, all compensating or addi-__ ,../ ,1 Local ttonaltax calculated pursuant to RCW 84.33,120 and 140 or RCW 84.34.10lS / In_r t Pe It. State shall be due and payable by the seller or transferor at the time of sail--/'"' lII'1uen na y. $ 1..-', The county assessor must determine if the land transferred quar s to, // Total Due $ U continue classification or designation and must so indicate below, S' natures i TaERE IS A $2.00 FEE FOR PROCESSING THIS FORM IF,NO TAX IS DUE do not necessarily mean the land will remain in classification or i na.-- -' tion. If it no longer qualifies, it will be removed and the compensating taxes will be applied. All new owners must sign. This land 0 does 0 does not qualify for continuance. Date & Place of Signing Signa\Ure of " Grantee/Agent 'j 'Name (p~int)' i . i . Date & Place of Signing PERjURY: P~rjury is a class C felony which is punishable by imprisonmenl in a stale correctional institulion for a maximum lerm of not more than five years, or by a fine in an amount fixed by the court of not more than five thousand dollars ($5,000,00), or by both imprisonmenl and fine (RCW 9A.20.020 (IC)). YES o IX! Classified or designated as forest land? Chapter 84.33 RCW Classified as current use land (open space, farm 0 and agricultural, or timber)? Chapter 84.34 RCW Exempt from property tax as a nonprofit organization? Chapler 84,36 RCW Seller's Exempt Reg. No. _ _ _ _ _ - _ __ Receiving special valuation as historic 0 property under? Chapter 84.26 RCW Property Type: 0 land only .g' land with previously used building D timber only ~ o IS(] [2l, o land with new building o land with mobile home o building only Date DEPUTY ASSESSOR (2) NOTICE OF COMPLIANCE (Chapter 84,26 RCW) 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. 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 and payable by the seller or transferor Alt the time of sale. (3) OWNER(S) SIGNATURE I /t1 In If exemption claimed, list WAC number and explanation. ~ '.AlAe 'iSP>-H- '+1':) WAC No. (See/Sub) Explanation ~ , ,-' ) 'I .L,W: " '1 1 ''"I I Type of Document ,-/.,5.-'., _"" ,. ,J.'.Ji--i ... ;'~ '. i i ,~' , . I , t' Date of Document '0 i $ $ $ $ $ $ $ d o o D :) D o I certify under penalty of perjury under the laws of the state of Washington that the. foregoing is true and correct. Signature of ;l) <J..----' . Grantor/Agent~. ~ -~ , . .J i ,-1,/;\ -., Name (print) i(, : ,. I 'If ,Ill ,0;;,-- .(\ , ......., FORr<{ REV 84 0001 A (7-6-94) (PD 01-10-95) FOR TREASURER'S USE ONLY TAXPAYER ---- .'- " ~, . ~{(VE~E State of Washington 0 0 DeparbnentofRevenue . REAL ESTATE EXCISE TAX Miscellaneous Tax Section . .... SUPPLEMENTAL STATEMENT .... ... PO Box 47477 Olympia WA 98504-7477 (WAC 458-61-150) This form must be submitted with the Real Estate Excise Tax Affidavit (FORM REV 84 OOOIA) for claims of tax exemption as provided below, Completion of this form is required for the types of real property transfers listed in numbers 1-5 below. Only the first white page of this form needs original signatures. A notary's signature is only required for l!ems 3 and 5. AUDIT: The transfer referred to on this document is subject to audit by the Department of Revenue under RCW 82.45.150. PERJURY: Petjury is a class C felony which is punishable by imprisonment in a state correctional institution for a maximum term of not more than five years, or by a fine in an amount fixed by the court of not more than five thousand dolIars ($5,000.00), or by both imprisonment and fine (RCW 9A.20,020 (1 Cll. The persons signing below do hereby swear under penalty of perjury that the folIowing is true (check appropriate statement): I. D DATE OF SALE: (WAC 458-61-090) I. (print name) certifY that the (type of instrument), dated . was delivered to me in escrow by (selIer's name). NOTE: Attorney. escrow agent, title company agent. or title insurance company agent named here must sign below and indicate name of firm. No notary is required. The payment of the tax is considered current if it is not more than 90 days beyond the date shown on the instrument. If it is past 90 days, interest and penalties apply to the date of the instrument. GIFTS: (WAC 458-61-410) One of tbe foUowing must be cbecked. (NOTE: For gifts, botb Grantor and Grantee must sign below. No notary is required.) ~ A. NO DEBT. Grantor gifts property which has no underlying debt. The transfer is without consideration and/or love and affection is the only consideration. See Example I on reverse. D B. THERE IS DEBT, BUT GRANTOR CONTINUES TO MAKE PAYMENTS. Grantor gifts property to Grantee and wilI continue to make alI payments on debt of $ (please state total debt, not mOntbly payment) Grantee will not be making any payments on the debt for which the Grantor is liable. The transfer is without consideration and/or love and affection is the only consideration. See Example 3 on reverse. D C. OTHER GIFT TRANSFERS. Grantor gifts the equity portion of the value of the property to the Grantee, Grantee will make payments toward the debt of $ (please state total debt, not montbly payment) for which the Grantor is liable. In addition, Grantee will pay the Grantor $ The transaction is taxable to the total of any consideration, including debt. Love and affection is not taxable. See Examples 2, 4, and 5 on reverse. 3. D INCORPORATOR: (WAC 458-61-375 (2G)). I, (print name) behalf of (print corporation name) currently being formed. NOTE: Grantee must sign below. Signature must be notarized. 4. D IRS "TAX DEFERRED" EXCHANGE: (WAC 458-61-480) I, (print name) . certifY that I am acting as an Exchange Facilitator in transferring real property to pursuant to IRC Section 1031, and in accordance with WAC 458-61-480. NOTE: Exchange Facilitator must sign below. No notary is required. 5. D NOMINEE: (WAC 458-61-550) I. (print name) . am acquiring the subject real property as nominee on behalf of (print name of third party principal) on (date of conveyance) NOTE: Grantee and principal must sign below. Both signatures must be notarized on or prior to the date of the conveyance to nominee, This statement must be attached to the Real Estate Tax Affidavit for transfer from nominee to principal. 2. . am acquiring the subject property on , Such corporation is Escrow Agent/ Attorney/Title Company Agent/Title Insurance Company Agent (Indicate name of firm): Grantor omineelEllcbange Facill Sig~ures: /{ .,' )/y1' 'r- . I..., ,II NOTARY: Required only for Incorporator (Item 3) or Nominee (Item 5). Subscribed and sworn to me this day of (Signature) . Notary Public Grantee/Principal/Incorporator Signatures: (Print Name) Distribution: Separate the copies of thlS form and attach to the Real Estate Excise Tax Affidavit as follows: 1) WHITE - Attach to County Treasurer's Original 2) CANARY - Attach to Dept. of Revenue's Copy 3) PINK - Attach to County Assessor's Copy 4) GOLD - Attach to Taxpayer's Copy REV 84 0002-1 (] 2.4-98) (PD 4-0] -99) in and for the state of residing at