1979, 04-11 Tax SegregationTAX SEGREGATION APPLICATION FORM
(Applicable to the division of one or more parcels of real property into
two or more parcels under different ownerships, also applies to
aggregation of parcels.)
NAME
ADDRESS IIJ-21 leP^--
PHONE NUMBER !J ` DATE
DELINQUENT
TAXES
PARCEL NO(S)
I. Enter legal descriptions of all portions to be segregated. Also
include legal description of portions remaining (use supplemental
sheet if needed).
II. Make drawing of entire property. Indicate approximate dimensions
of all property lines. Indicate on which portions of property any
buildings should remain. If a copy of a survey is available, please
attach to this form.
Ill. This application is to be completed in its entirety before processing.
NOTE: The approval of this application by the County Assessor or his
appointee shall not be construed as authorizing the division of lands for
the purposes of sale or subdivision in violation of RCW 58.17 (Plat and
Subdivision Act). The taxpayer is hereby advised that no segregation
will take place until this form is completed.
Applicant Signature
THIS AREA FOR USE BY APPLICANT FOR LEGAL
DESCRIPTIONS AND DRAWINGS. USE REVERSE SIDE IF
NEEDED.
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