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5512159 Mansfield No. 2112, ZE-109-80Pa: I of 2 9[12005 09198 55 II VIII VIII VIIII IVIIII III III VIII I II 0 SNIH[ ;0 EII31i6(F1116 4M W 00 tpnlm !o IN After Recording Return To: Spokane County Engineer's Office Attn.: Right of Way Department 1026 West Broadway Avenue Spokane, WA 99260-0170 Document Title: Right of Way Deed Grantors: Bethel, Robert N. and Deborah G. Grantee: Government, City of Spokane Valley Legal Description: SE 1/4 of Section 9, Township 25 N., Range 44 EWM, Spokane Valley, Washington. Additional Legal Description: See Page I Assessor's Tax Parcel Number: 45094.0520 Zone Change ZE-109-80 CITY OF SPOKANE VALLEY DIVISION OF ENGINEERING Spokane County, Washington RIGHT OF WAY DEED IN THE MATTER OF MANSFIELD AVENUE RFNO.2112 KNOW ALL MEN BY THESE PRESENTS, that the Grantors, Robert N. Bethel and Deborah G. Bethel, for and in consideration of Mutual Benefits, grants and conveys to the City of Spokane Valley, the following described parcel of land, situated in Spokane County, State of Washington, to-wit: PORTION OF ASSESSORS PARCEL NO. 45094.0520 w nu w ru 0 0 w~ f'6 O f O 0 0 0 w W N That portion of Lots 21 and 22, PINECROFT FIRST ADDITION, of Plat recorded in Volume "M" of Plats, Page 35, lying Northerly of a line lying 24.00 feet Southerly and parallel to the Proposed Center Line for Mansfield Avenue as per Survey recorded under Spokane County Auditor's Recording No. 5497724, Book 126, Page 13. Located in the Southeast Quarter (SE1/4) of Section 9, Township 25 North, Range 44 East, W.M., City of Spokane Valley, County of Spokane, State of Washington TO HAVE AND TO HOLD the same, unto the said City of Spokane Valley for the purposes of a public road forever. IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIII 5512159 SP01--A1E iJ Lf.GiiiEE4I14131 R0D 00 Spokane C0, WA IN WITNESS WHER F, we have hereunto set our hands and seal this _ day of , 2007. 61 By: obert N. Be el By: eborah G. Bethel STATE OF WASHINGTON ) COUNTY OF SPOKANE ) ss I certify that I know or have satisfactory evidence that Robert N. Bethel and Deborah G. Bethel are the individuals who appeared before me, and said individuals acknowledged that they signed this instrument, and acknowledged it as their free and voluntary act, for the uses and purposes mentioned in the instrument. Dated this / Z3- day of MA Q- C t ( 52007. NOTARY PUBLIC STATE CF WASHINGTON FREDERICK J. FOSS My appointment expires March 15, 2008 NOTARY PUBL C In and for the State of Washington, residing at Spokane. My appointment expires: 3 - ~S- 2L-w8 FW___ RTMEWTiTON STATE REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt PLEASE TYPE OR PRINT CHAPTER 82.45 RCW - CHAPTER 458-61A WAC when stamped by cashier. THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED (See back of last page for instructions) Check box if partial sale of property If multiple owners. list percentaee of ownership next to name- 1 r Name ~~'J .t `K'..L [ L ~'-~tr :4 ~ Name W L I Spokane County W. 0 Z LLI Mailing Address r 4 r, City/StatelZip Phone No. (including area code) _ : t - 1 t1 - 7 • L LLI Z v Right of Mailing Address Way IOn 1026 W Broadway Ave City/State/Zip 99260-0170 Spokane, Phone No. (including area code) Send all property tax correspondence to: [3 Same as Buyer/G Name , - ter List all real and personal property tax parcel account numbers . cttmk box if personal property \_~r ❑ List assessed value(s) Mailing Address L ❑ City/State/Zip ❑ Phone No. (including area code) ❑ Street address of property: . ! l)` r K E C r , a This property is located in ❑ unincorporated County OR within Q 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) . Enter Abstract Use Categories: (See back of last page for instructions) If exempt from property tax per chapter 84.36 RCW (nonprofit organization), include: Seller's Exempt Reg. No.: YES NO Is this property designated as forest land per chapter 84.33 RCW? ❑ Is this property classified as current use (open space, farm and ❑ agricultural, or timber) land per chapter 84.34? Is this property receiving special valuation as historical property ❑ per chapter 84.26 RCW? 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 RCW 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 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) do not wish to continue, all additional tax calculated pursuant to chapter 84.26 RCW, shall be due and payable by the seller or transferor at the time of sale. (3) 0%'NER(S) SIGNATURE List all personal property (tangible and intangible) included in selling price. If claiming an exemption, list WAC number and reason for exemption: ! ~I WAC No. (Section/Subsection) t rte 1 S - 3 F - Reason for exemption`") Q U.S2.) li r C Type of Document LOCI Date of Document -1 Gross Selling Price *Personal Property (deduct) Exemption Claimed (deduct) Taxable Selling Price Excise Tax: State Local *Delinquent Interest: State Local *Delinquent Penalty Subtotal *County Technology Fee *State Technology Fee *Affidavit Processing Fee Total Due t-A $ $ 't $ D✓ A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX *SEE INSTRUCTIONS I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Signature of • .-w . I A LE' L Y Grantor or Grantor's Agent t _ l Grantee or Grantee's Agent Name (print) i Name (print) Date & city of signing: 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 (I Q. REV 84 0001a (01A2'06) THIS SPACE - TREASURER'S USE ONLY TAXPAYER 3/21/2007 J.DF s i 0.00 200704112 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'Rc-turn. Revenue Form No. 84-0001B. This form is available at your local County Treasurer's or Recorder's Office or online at http:ildor.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 -tame(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 niunic:ipalitv. • Enter the legal descrintinn ~if the nrontrti, Section PORTION OF ASSESSORS PARCEL NO. 45094.0520 • Enter the apt 1 Residen That portion of Lots 21 and 22, PINL;CROI~T FIRST ADDITION, to Plat ~ 2 -Residen Tula p recorded in Volume "M" of Plats, Page 35, lying Northerly of a line lying 24.00 3 - Manufa( 4 - Commt, feet Southerly and parallel to the Proposed Center Line for Mansfield 5497724, 5 - Agricult per Survey recorded under Spokane County Auditors Recording No. 6 - Agricult Book 126, Page 13. 7 - Designa 8 - Open Sr • Seller's Fxen Section 0: _ the Southeast Quarter (SF.l/4) of Section 9, Township 25 North, Range Indi~.~i: t~ctl~ Located in th agricultural, w, 44 Last, W.M., City of Spokane Valley, County of Spokane, State of Washington Section 7: • List personal ment, etc) and intangible (goo(:iwttt, agreement not to compete, etc). • L'se Tax is due on personal property purchased without payment of the sales tax. Use Tax may be reported on your Combined Excise lax 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 458-61A WAC is available online at http:, dor.wa.gov. • I=nter the type of document (quit claim deed, statutory warranty deed, etc.), and date of document (MWDD/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': 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 458-61A 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. Note: Original signatures required on the "County Treasurer" copy. Signatures may be required on the "Assessors" copy. Check with your county. Where to send completed forms: 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 (3660) 705-6655 For tax assistance, contact your local County Treasurer%Recorder or 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. Telet_yTc (TTY) users please call 1-800-451-7985. RED` 84 000 1a inst. (01,'12!06)