Form Rev 84 0001Ae PDF Details

Form Rev 84 0001Ae is a revocable living trust form created by the state of California. This form can be used to create a trust for the benefit of one or more individuals, and allows for flexibility in terms of who will manage the trust and how its assets will be distributed. The revocable living trust may also be amended or revoked at any time, making it an ideal choice for those who want to have some degree of control over their estate planning. To learn more about this form and how it can benefit you, keep reading.

QuestionAnswer
Form NameForm Rev 84 0001Ae
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other names84-0001B, unincorporated, Underpayments, GRANTEE

Form Preview Example

PLEASE TYPE OR PRINT

REAL ESTATE EXCISE TAX AFFIDAVIT

This form is your receipt

CHAPTER 82.45 RCW – CHAPTER 458-61 WAC

when stamped by cashier.

 

 

 

 

 

 

 

 

THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED

 

 

 

 

 

 

 

 

 

 

 

 

(See back page for instructions)

 

 

 

 

 

 

 

 

Check box if partial sale of property

 

 

 

 

 

 

 

 

If multiple owners, list percentage of ownership next to name.

 

1

 

 

Name

 

 

 

 

 

2

 

Name

 

 

SELLER GRANTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BUYER GRANTEE

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

Send all property tax correspondence to: Same as Buyer/Grantee

 

List all real and personal property tax parcel account

 

List assessed value(s)

 

 

 

 

 

 

 

numbers – check box if personal property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No. (with area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4Street address of property:

This property is located in

unincorporated

 

County OR within

city of

Check box if any of the listed parcels are being segregated from a larger parcel.

 

 

Legal description of property (if more space is needed, you may attach a separate sheet to each page of the affidavit)

5

Enter Abstract Use Categories:

 

 

 

 

 

7

List all personal property (tangible and intangible) included in selling

 

 

(Please see list on the back page of this form)

 

 

 

 

 

price.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If exempt from property tax per chapter 84.36 RCW (nonprofit

 

 

 

 

 

 

 

 

 

 

 

 

organization), include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Seller’s Exempt Reg. No.:

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

YES NO

If claiming an exemption, list WAC number and reason for exemption:

 

Is this property designated as forest land per chapter 84.33 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property classified as current use (open space, farm and

 

 

 

 

WAC No. (Section/Subsection)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

agricultural, or timber) land per chapter 84.34?

 

 

 

 

Reason for exemption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property receiving special valuation as historical property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

per chapter 84.26 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If any answers are yes, complete as instructed below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NOTICEOFCONTINUANCE (FORESTLANDORCURRENTUSE)

Type of Document

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW OWNER(S): To continue the current designation as forest land or

Date of Document

 

 

 

 

classification as current use (open space, farm and agriculture, or timber)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

land, you must sign on (3) below. The county assessor must then determine

 

Gross Selling Price

$

 

 

 

if the land transferred continues to qualify and will indicate by signing below.

 

 

 

 

 

*Personal Property (deduct)

$

 

 

 

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

 

Exemption Claimed (deduct) $

 

will be due and payable by the seller or transferor at the time of sale. (RCW

 

 

 

Taxable Selling Price

$

 

 

 

84.33.140 or RCW 84.34.108). Prior to signing (3) below, you may contact

 

 

 

 

 

Excise Tax: State

$

 

 

 

your local county assessor for more information.

 

 

 

 

 

 

 

 

This land

does

does not qualify for continuance.

 

 

 

 

 

 

 

 

Local $

 

 

 

 

 

 

*Delinquent Interest: State

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local $

 

 

 

DEPUTY ASSESSOR

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) NOTICE OFCOMPLIANCE(HISTORICPROPERTY)

 

*Delinquent Penalty

$

 

 

 

NEW OWNER(S): To continue special valuation as historic property,

 

*County Technology Fee $

 

sign (3) below. If the new owner(s) do not wish to continue, all

 

 

 

 

 

 

 

 

 

 

 

 

 

additional tax calculated pursuant to chapter 84.26 RCW, shall be due

 

*State Technology Fee

$

 

 

 

and payable by the seller or transferor at the time of sale.

 

 

 

 

 

*Affidavit Processing Fee

$

 

 

 

 

 

 

(3) OWNER(S) SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Due $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*SEE INSTRUCTIONS

 

8

 

 

I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

Grantor or Grantor’s Agent

 

 

 

 

 

Grantee or Grantee’s Agent

 

 

 

 

Name (print)

Date & city of signing:

Name (print)

Date & city of signing:

Perjury: Perjury is a class C felony which is punishable by imprisonment in the 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 dollars ($5,000.00), or by both imprisonment and fine (RCW 9A.20.020 (1C)).

REV 84 0001ae (a) (07/11/05)

THIS SPACE - TREASURER’S USE ONLY

COUNTY TREASURER

PLEASE TYPE OR PRINT

REAL ESTATE EXCISE TAX AFFIDAVIT

This form is your receipt

CHAPTER 82.45 RCW – CHAPTER 458-61 WAC

when stamped by cashier.

 

 

 

 

 

 

 

 

THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED

 

 

 

 

 

 

 

 

 

 

 

 

(See back page for instructions)

 

 

 

 

 

 

 

 

Check box if partial sale of property

 

 

 

 

 

 

 

 

If multiple owners, list percentage of ownership next to name.

 

1

 

 

Name

 

 

 

 

 

2

 

Name

 

 

SELLER GRANTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BUYER GRANTEE

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

Send all property tax correspondence to: Same as Buyer/Grantee

 

List all real and personal property tax parcel account

 

List assessed value(s)

 

 

 

 

 

 

 

numbers – check box if personal property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No. (with area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4Street address of property:

This property is located in

unincorporated

 

County OR within

city of

Check box if any of the listed parcels are being segregated from a larger parcel.

 

 

Legal description of property (if more space is needed, you may attach a separate sheet to each page of the affidavit)

5

Enter Abstract Use Categories:

 

 

 

 

 

7

List all personal property (tangible and intangible) included in selling

 

 

(Please see list on the back page of this form)

 

 

 

 

 

price.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If exempt from property tax per chapter 84.36 RCW (nonprofit

 

 

 

 

 

 

 

 

 

 

 

 

organization), include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Seller’s Exempt Reg. No.:

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

YES NO

If claiming an exemption, list WAC number and reason for exemption:

 

Is this property designated as forest land per chapter 84.33 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property classified as current use (open space, farm and

 

 

 

 

WAC No. (Section/Subsection)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

agricultural, or timber) land per chapter 84.34?

 

 

 

 

Reason for exemption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property receiving special valuation as historical property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

per chapter 84.26 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If any answers are yes, complete as instructed below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NOTICEOFCONTINUANCE (FORESTLANDORCURRENTUSE)

Type of Document

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW OWNER(S): To continue the current designation as forest land or

Date of Document

 

 

 

 

classification as current use (open space, farm and agriculture, or timber)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

land, you must sign on (3) below. The county assessor must then determine

 

Gross Selling Price

$

 

 

 

if the land transferred continues to qualify and will indicate by signing below.

 

 

 

 

 

*Personal Property (deduct)

$

 

 

 

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

 

Exemption Claimed (deduct) $

 

will be due and payable by the seller or transferor at the time of sale. (RCW

 

 

 

Taxable Selling Price

$

 

 

 

84.33.140 or RCW 84.34.108). Prior to signing (3) below, you may contact

 

 

 

 

 

Excise Tax: State

$

 

 

 

your local county assessor for more information.

 

 

 

 

 

 

 

 

This land

does

does not qualify for continuance.

 

 

 

 

 

 

 

 

Local $

 

 

 

 

 

 

*Delinquent Interest: State

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local $

 

 

 

DEPUTY ASSESSOR

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) NOTICE OFCOMPLIANCE(HISTORICPROPERTY)

 

*Delinquent Penalty

$

 

 

 

NEW OWNER(S): To continue special valuation as historic property,

 

*County Technology Fee $

 

sign (3) below. If the new owner(s) do not wish to continue, all

 

 

 

 

 

 

 

 

 

 

 

 

 

additional tax calculated pursuant to chapter 84.26 RCW, shall be due

 

*State Technology Fee

$

 

 

 

and payable by the seller or transferor at the time of sale.

 

 

 

 

 

*Affidavit Processing Fee

$

 

 

 

 

 

 

(3) OWNER(S) SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Due $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*SEE INSTRUCTIONS

 

8

 

 

I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

Grantor or Grantor’s Agent

 

 

 

 

 

Grantee or Grantee’s Agent

 

 

 

 

Name (print)

Date & city of signing:

Name (print)

Date & city of signing:

Perjury: Perjury is a class C felony which is punishable by imprisonment in the 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 dollars ($5,000.00), or by both imprisonment and fine (RCW 9A.20.020 (1C)).

REV 84 0001ae (a) (07/11/05)

THIS SPACE - TREASURER’S USE ONLY

COUNTY ASSESSOR

PLEASE TYPE OR PRINT

REAL ESTATE EXCISE TAX AFFIDAVIT

This form is your receipt

CHAPTER 82.45 RCW – CHAPTER 458-61 WAC

when stamped by cashier.

 

 

 

 

 

 

 

 

THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED

 

 

 

 

 

 

 

 

 

 

 

 

(See back page for instructions)

 

 

 

 

 

 

 

 

Check box if partial sale of property

 

 

 

 

 

 

 

 

If multiple owners, list percentage of ownership next to name.

 

1

 

 

Name

 

 

 

 

 

2

 

Name

 

 

SELLER GRANTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BUYER GRANTEE

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

Send all property tax correspondence to: Same as Buyer/Grantee

 

List all real and personal property tax parcel account

 

List assessed value(s)

 

 

 

 

 

 

 

numbers – check box if personal property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No. (with area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4Street address of property:

This property is located in

unincorporated

 

County OR within

city of

Check box if any of the listed parcels are being segregated from a larger parcel.

 

 

Legal description of property (if more space is needed, you may attach a separate sheet to each page of the affidavit)

5

Enter Abstract Use Categories:

 

 

 

 

 

7

List all personal property (tangible and intangible) included in selling

 

 

(Please see list on the back page of this form)

 

 

 

 

 

price.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If exempt from property tax per chapter 84.36 RCW (nonprofit

 

 

 

 

 

 

 

 

 

 

 

 

organization), include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Seller’s Exempt Reg. No.:

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

YES NO

If claiming an exemption, list WAC number and reason for exemption:

 

Is this property designated as forest land per chapter 84.33 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property classified as current use (open space, farm and

 

 

 

 

WAC No. (Section/Subsection)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

agricultural, or timber) land per chapter 84.34?

 

 

 

 

Reason for exemption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property receiving special valuation as historical property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

per chapter 84.26 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If any answers are yes, complete as instructed below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NOTICEOFCONTINUANCE (FORESTLANDORCURRENTUSE)

Type of Document

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW OWNER(S): To continue the current designation as forest land or

Date of Document

 

 

 

 

classification as current use (open space, farm and agriculture, or timber)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

land, you must sign on (3) below. The county assessor must then determine

 

Gross Selling Price

$

 

 

 

if the land transferred continues to qualify and will indicate by signing below.

 

 

 

 

 

*Personal Property (deduct)

$

 

 

 

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

 

Exemption Claimed (deduct) $

 

will be due and payable by the seller or transferor at the time of sale. (RCW

 

 

 

Taxable Selling Price

$

 

 

 

84.33.140 or RCW 84.34.108). Prior to signing (3) below, you may contact

 

 

 

 

 

Excise Tax: State

$

 

 

 

your local county assessor for more information.

 

 

 

 

 

 

 

 

This land

does

does not qualify for continuance.

 

 

 

 

 

 

 

 

Local $

 

 

 

 

 

 

*Delinquent Interest: State

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local $

 

 

 

DEPUTY ASSESSOR

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) NOTICE OFCOMPLIANCE(HISTORICPROPERTY)

 

*Delinquent Penalty

$

 

 

 

NEW OWNER(S): To continue special valuation as historic property,

 

*County Technology Fee $

 

sign (3) below. If the new owner(s) do not wish to continue, all

 

 

 

 

 

 

 

 

 

 

 

 

 

additional tax calculated pursuant to chapter 84.26 RCW, shall be due

 

*State Technology Fee

$

 

 

 

and payable by the seller or transferor at the time of sale.

 

 

 

 

 

*Affidavit Processing Fee

$

 

 

 

 

 

 

(3) OWNER(S) SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Due $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*SEE INSTRUCTIONS

 

8

 

 

I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

Grantor or Grantor’s Agent

 

 

 

 

 

Grantee or Grantee’s Agent

 

 

 

 

Name (print)

Date & city of signing:

Name (print)

Date & city of signing:

Perjury: Perjury is a class C felony which is punishable by imprisonment in the 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 dollars ($5,000.00), or by both imprisonment and fine (RCW 9A.20.020 (1C)).

REV 84 0001ae (a) (07/11/05)

THIS SPACE - TREASURER’S USE ONLY

DEPT. OF REVENUE

PLEASE TYPE OR PRINT

REAL ESTATE EXCISE TAX AFFIDAVIT

This form is your receipt

CHAPTER 82.45 RCW – CHAPTER 458-61 WAC

when stamped by cashier.

 

 

 

 

 

 

 

 

THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED

 

 

 

 

 

 

 

 

 

 

 

 

(See back page for instructions)

 

 

 

 

 

 

 

 

Check box if partial sale of property

 

 

 

 

 

 

 

 

If multiple owners, list percentage of ownership next to name.

 

1

 

 

Name

 

 

 

 

 

2

 

Name

 

 

SELLER GRANTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BUYER GRANTEE

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

Phone No. (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

Send all property tax correspondence to: Same as Buyer/Grantee

 

List all real and personal property tax parcel account

 

List assessed value(s)

 

 

 

 

 

 

 

numbers – check box if personal property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No. (with area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4Street address of property:

This property is located in

unincorporated

 

County OR within

city of

Check box if any of the listed parcels are being segregated from a larger parcel.

 

 

Legal description of property (if more space is needed, you may attach a separate sheet to each page of the affidavit)

5

Enter Abstract Use Categories:

 

 

 

 

 

7

List all personal property (tangible and intangible) included in selling

 

 

(Please see list on the back page of this form)

 

 

 

 

 

price.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If exempt from property tax per chapter 84.36 RCW (nonprofit

 

 

 

 

 

 

 

 

 

 

 

 

organization), include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Seller’s Exempt Reg. No.:

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

YES NO

If claiming an exemption, list WAC number and reason for exemption:

 

Is this property designated as forest land per chapter 84.33 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property classified as current use (open space, farm and

 

 

 

 

WAC No. (Section/Subsection)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

agricultural, or timber) land per chapter 84.34?

 

 

 

 

Reason for exemption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is this property receiving special valuation as historical property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

per chapter 84.26 RCW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If any answers are yes, complete as instructed below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NOTICEOFCONTINUANCE (FORESTLANDORCURRENTUSE)

Type of Document

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW OWNER(S): To continue the current designation as forest land or

Date of Document

 

 

 

 

classification as current use (open space, farm and agriculture, or timber)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

land, you must sign on (3) below. The county assessor must then determine

 

Gross Selling Price

$

 

 

 

if the land transferred continues to qualify and will indicate by signing below.

 

 

 

 

 

*Personal Property (deduct)

$

 

 

 

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

 

Exemption Claimed (deduct) $

 

will be due and payable by the seller or transferor at the time of sale. (RCW

 

 

 

Taxable Selling Price

$

 

 

 

84.33.140 or RCW 84.34.108). Prior to signing (3) below, you may contact

 

 

 

 

 

Excise Tax: State

$

 

 

 

your local county assessor for more information.

 

 

 

 

 

 

 

 

This land

does

does not qualify for continuance.

 

 

 

 

 

 

 

 

Local $

 

 

 

 

 

 

*Delinquent Interest: State

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local $

 

 

 

DEPUTY ASSESSOR

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) NOTICE OFCOMPLIANCE(HISTORICPROPERTY)

 

*Delinquent Penalty

$

 

 

 

NEW OWNER(S): To continue special valuation as historic property,

 

*County Technology Fee $

 

sign (3) below. If the new owner(s) do not wish to continue, all

 

 

 

 

 

 

 

 

 

 

 

 

 

additional tax calculated pursuant to chapter 84.26 RCW, shall be due

 

*State Technology Fee

$

 

 

 

and payable by the seller or transferor at the time of sale.

 

 

 

 

 

*Affidavit Processing Fee

$

 

 

 

 

 

 

(3) OWNER(S) SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Due $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*SEE INSTRUCTIONS

 

8

 

 

I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of

 

 

 

 

Grantor or Grantor’s Agent

 

 

 

 

 

Grantee or Grantee’s Agent

 

 

 

 

Name (print)

Date & city of signing:

Name (print)

Date & city of signing:

Perjury: Perjury is a class C felony which is punishable by imprisonment in the 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 dollars ($5,000.00), or by both imprisonment and fine (RCW 9A.20.020 (1C)).

REV 84 0001ae (a) (07/11/05)

THIS SPACE - TREASURER’S USE ONLY

TAXPAYER

INSTRUCTIONS

Note: To report a transfer of a controlling interest in an entity with an interest in real property, please use Real Estate Excise Tax Affidavit/Return, Revenue Form No. 84-0001B. This form is available at your local County Treasurer's or Recorder’s Office or online at http://dor.wa.gov.

Section 1:

Enter the name(s) of seller/grantor. This is the person(s) conveying interest in the property.

Section 2:

Enter the name(s) of buyer/grantee. This is the person(s) receiving interest in the property.

Section 3:

Enter the name and address where you would like all future property tax information sent.

Enter the tax parcel number and current assessed value for real and personal property being conveyed. Check the box to indicate personal property.

Section 4:

Enter the street address of the property.

Enter the county if in unincorporated area or city if located within a municipality.

Enter the legal description of the property.

Section 5:

• Enter the appropriate Abstract Use Category for the property. WAC 458-53-050. Select all that apply.

1

– Residential, Single

9

– Timberland Current Use (ch. 84.34 RCW)

2

– Residential, Multiple

10

– Other

3

– Manufacturing

11

– Land with Mobile Home

4

– Commercial

12

– Standing Timber (separate from land)

5

– Agriculture (not in Current Use)

13

– Water Right or Mineral Right

6

– Agricultural Current Use (ch. 84.34 RCW)

14

– Undeveloped Land / Land Only

7

– Designated Forest Land (ch. 84.33 RCW)

15

– Land with New Building

8

– Open Space Current Use (ch. 84.34 RCW)

16

– Building Only

• Seller’s Exempt Registration Number is 9-digit UBI number.

Section 6:

Indicate whether the property is designated as forest land per chapter 84.33 RCW, classified as current use (open space, farm, agricultural, or timber) per chapter 84.34 RCW, or receiving special valuation as historic property per chapter 84.26 RCW.

Section 7:

List personal property included in the selling price of the real property. For example, include tangible (furniture, equipment, etc) and intangible (goodwill, agreement not to compete, etc).

Use Tax is due on personal property purchased without payment of the sales tax. Use Tax may be reported on your Combined Excise Tax Return or a Consumer Use Tax Return, both available at http://dor.wa.gov.

If you are claiming a tax exemption, cite the specific Washington Administrative Code (WAC) number, section and subsection and provide a brief explanation. Most tax exemptions require specific documentation. Refer to the appropriate WAC to determine documentation requirements. Chapter 458-61 WAC is available online at http://dor.wa.gov.

Enter the type of document (quit claim deed, statutory warranty deed, etc.), and date of document (MM/DD/YYYY)

Enter the selling price of the property.

Selling price: For tax purposes, the selling price is the true and fair value of the property conveyed. When property is conveyed in an arm’s length transaction between unrelated persons for valuable consideration, there is a presumption that the selling price is equal to the total consideration paid or contracted to be paid, including any indebtedness. Refer to RCW 82.45.030 for more information about selling price.

Deduct the amount of personal property included in the selling price.

Deduct the amount of tax exemption claimed per chapter 458-61 WAC.

Due Date, Interest and Penalties: Tax is due at the time of sale/transfer. If tax is not paid within one month of the date of sale/transfer, interest and penalties will apply. The interest rate is variable and determined per RCW 82.32.050. Delinquent penalties are 5% one month after the due date; 10% two months after the due date; and 20% three months after the due date. (RCW 82.45.100)

County Technology Fee - A $5.00 Electronic Technology Fee that is due on all transactions where no tax is due and where tax due is less than $5.00

State Technology Fee - A $5.00 Electronic Technology Fee that is due on all taxable transactions.

Affidavit Processing Fee - A minimum of $5.00 shall be collected in the form of tax and processing fee. A processing fee is due on all transactions where no tax is due and on all taxable transactions where the tax due is less than $5.00.

Section 8:

Both grantor (seller) and grantee (buyer), or the agent of each, must sign this form, certifying that all the information provided is correct. Completed forms should be submitted to the County Treasurer's or Recorder’s Office where the property is located.

Audit:

Information you provide on this form is subject to audit by the Department of Revenue. Underpayments of tax will result in the issuance of a tax assessment with interest and penalties. Note: in the event of an audit, it is the taxpayers’ responsibility to provide documentation to support the selling price or any exemption claimed. This documentation must be maintained for a minimum of four years from

date of sale. (RCW 82.45.100)

Ruling requests:

You may request a predetermination of your tax liability. The written opinion will be binding on both you and the Department based on the facts presented (WAC 458-20-100(9)). Send your ruling request to:

Department of Revenue

Taxpayer Information & Education P.O. Box 47478

Olympia, WA 98504-7478 FAX (360) 705-6655

For tax assistance, visit http://dor.wa.gov or call (360) 570-3265. To inquire about the availability of this document in an alternate format for the visually impaired, please call (360) 705-6715. Teletype (TTY) users please call 1-800-451-7985.

REV 84 0001ae (a) inst. (07/11/05)

How to Edit Form Rev 84 0001Ae Online for Free

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Be attentive while completing this document. Ensure each field is filled out accurately.

1. The Washington needs certain details to be typed in. Ensure the next blank fields are complete:

How to fill in 0001ae stage 1

2. Your next step is to fill in the next few blank fields: Select Land Use Codes, List all personal property, price, enter any additional codes See, Was the seller receiving a, YES, YES NO, If claiming an exemption list WAC, Is this property designated as, WAC No SectionSubsection, Is this property classified as, Is this property receiving special, If any answers are yes complete as, NOTICE OF CONTINUANCE FOREST LAND, and Reason for exemption.

Completing segment 2 in 0001ae

3. In this specific part, examine This land, does, does not qualify for continuance, DEPUTY ASSESSOR, DATE, NOTICE OF COMPLIANCE HISTORIC, NEW OWNERS To continue special, OWNERS SIGNATURE, Delinquent Interest State, Local, Delinquent Penalty, Subtotal, State Technology Fee, Affidavit Processing Fee, and Total Due. All of these should be filled out with greatest accuracy.

Part number 3 of filling out 0001ae

4. To move ahead, this next section involves typing in several form blanks. These include THIS AFFIDAVIT WILL NOT BE, Check box if partial sale, See back of last page for, Name, R E L L E S, R O T N A R G, Mailing Address, CityStateZip, List percentage of ownership, Name, R E Y U B, E E T N A R G, Mailing Address, CityStateZip, and Phone No including area code, which you'll find essential to carrying on with this particular PDF.

How to prepare 0001ae stage 4

5. Now, the following final subsection is what you should wrap up before closing the form. The blanks here include the next: enter any additional codes See, Was the seller receiving a, YES, YES NO, If claiming an exemption list WAC, Is this property designated as, WAC No SectionSubsection, Is this property classified as, Is this property receiving special, If any answers are yes complete as, NOTICE OF CONTINUANCE FOREST LAND, This land, does, does not qualify for continuance, and DEPUTY ASSESSOR.

Part number 5 for submitting 0001ae

Be really attentive while filling out does not qualify for continuance and If claiming an exemption list WAC, since this is the part where most people make errors.

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