Washington Real Estate Excise Tax Mobile Home Affidavit

Real Estate Excise Tax Mobile Home Affidavit
MOBILE HOMEReset form

MOBILE HOME
REAL ESTATE EXCISE TAX AFFIDAVIT
Chapter 82.45 RCW
Chapter 458-61A WAC

Submit to County Treasurer of the
county in which property is located.

This form is your receipt when stamped
by cashier.
Used for sales on or after March 1, 2023

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY
PLEASE TYPE OR PRINT
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY AND ACCURATELY COMPLETED.

Street
City

State

Zip code

Phone number
Name

Street
City

State

Zip code

NEW REGISTERED
OWNER (Buyer)

Name

LEGAL OWNER

LOCATION OF
MOBILE HOME

R E GI S T E R E D
OWNER (Seller)

Name

Street
City

City

LIST ASSESSED VALUE(S): $

SIZE

SERIAL NO. or I.D.

State........................................... $

0.00

Local.......................................... $

0.00

Delinquent Interest: State ............................... $

0.00

Local .............................. $
Subtotal ............................................................ $

0.00
0.00
0.00

State Technology Fee ....................................... $

5.00

Signature of
Buyer/Agent

Affidavit Processing Fee................................... $

5.00

Name (print)

Total Due .......................................................... $

10.00

Delinquent Penalty ........................................... $

If exemption claimed, WAC number & title:
WAC No. (Sec/Sub)
WAC Title
A MINIMUM OF $10.00 IS DUE IN FEE(S) AND/OR TAX.
TREASURER’S CERTIFICATE
I hereby certify that property taxes due
County on the mobile home described hereon have been paid to and
including the year
.
Date

REVENUE TAX
CODE NO.

Yes

AFFIDAVIT
I certify under penalty of perjury under the laws of the State of
Washington that the foregoing is true and correct.

0.00

Select Location

Zip code

Street

LIST ASSESSED VALUE(S): $

MODEL

State

Name

REAL PROPERTY
PARCEL or ACCOUNT NO.

YEAR

Zip code

Phone number

PERSONAL PROPERTY
PARCEL or ACCOUNT NO.

MAKE

State

Signature of
Seller/Agent
Name (print)
Date and Place of Signing:

Date & Place of Signing:
Perjury in the second degree is a class C felony which is punishable by
confinement in a state correctional institution for a maximum term of
five years, or by a fine in an amount fixed by the court of not more than
$10,000, or by both such confinement and fine (RCW 9A.72.030 and
RCW 9A.20.021(1)(c)).
If, in selling (or otherwise transferring ownership of) a mobile home
which possesses a tax lien, the seller does not inform the buyer (new
owner) of such a lien, the seller is guilty of deliberate deception as it
applies to Fraud and/or Theft as defined in Title 9 and 9A RCW
(RCW 9.45.060, RCW 9A.56.010 (4d), and RCW 9A.56.020).

County Treasurer or Deputy

THIS SPACE - TREASURER’S USE ONLY
REV 84 0003e (02/28/23) COUNTY TREASURER

Print This Form

MOBILE HOME
REAL ESTATE EXCISE TAX AFFIDAVIT
Chapter 82.45 RCW
Chapter 458-61A WAC

Submit to County Treasurer of the county
in which property is located.

This form is your receipt when stamped by
cashier.
Used for sales on or after March 1, 2023

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY
PLEASE TYPE OR PRINT
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY AND ACCURATELY COMPLETED.

Street
City

State

Zip code

Phone number
Name

Street
City

State

Zip code

NEW REGISTERED
OWNER (Buyer)

Name

LEGAL OWNER

LOCATION OF
MOBILE HOME

R E GI S T E R E D
OWNER (Seller)

Name

Street
City

Zip code

Street
City

LIST ASSESSED VALUE(S): $

MODEL

State

Name

REAL PROPERTY
PARCEL or ACCOUNT NO.

YEAR

Zip code

Phone number

PERSONAL PROPERTY
PARCEL or ACCOUNT NO.

MAKE

State

SIZE

SERIAL NO. or I.D.

REVENUE TAX
CODE NO.

Is this property predominantly used for timber (as classified under RCW 84.34 and 84.33) or agriculture (as classified under
RCW 84.34.020) and will continue in its current use? If yes and the transfer involves multiple parcels with different
Yes
classifications, complete the predominate use calculator (see instructions).
AFFIDAVIT
Date of Sale
I certify under penalty of perjury under the laws of the State of
0.00
Taxable Sale Price ............................................ $
Washington that the foregoing is true and correct.
0.00
Excise Tax: State .......................................... $
Signature of
0.00
Local ......................................... $
Select Location
Seller/Agent
0.00
Delinquent Interest: State .............................. $
Name (print)
0.00
Local ............................. $
Date and Place of Signing:
0.00
Delinquent Penalty .......................................... $
Subtotal ............................................................ $

0.00

State Technology Fee ....................................... $

5.00

Signature of
Buyer/Agent

Affidavit Processing Fee .................................. $

5.00

Name (print)

Total Due.......................................................... $

10.00

County Treasurer or Deputy

THIS SPACE - TREASURER’S USE ONLY
REV 84 0003e (02/28/23) COUNTY ASSESSOR

MOBILE HOME
REAL ESTATE EXCISE TAX AFFIDAVIT
This form is your receipt when stamped by
cashier.
Used for sales on or after March 1, 2023

Chapter 82.45 RCW
Chapter 458-61A WAC

Submit to County Treasurer of the county
in which property is located.

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY
PLEASE TYPE OR PRINT
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY AND ACCURATELY COMPLETED.

Street
City

State

Zip code

Phone number
Name

Street
City

State

Zip code

NEW REGISTERED
OWNER (Buyer)

Name

LEGAL OWNER

LOCATION OF
MOBILE HOME

R E GI S T E R E D
OWNER (Seller)

Name

Street
City

Zip code

Street
City

LIST ASSESSED VALUE(S): $

MODEL

State

Name

REAL PROPERTY
PARCEL or ACCOUNT NO.

YEAR

Zip code

Phone number

PERSONAL PROPERTY
PARCEL or ACCOUNT NO.

MAKE

State

SIZE

SERIAL NO. or I.D.

REVENUE TAX
CODE NO.

Is this property predominantly used for timber (as classified under RCW 84.34 and 84.33) or agriculture (as classified under
RCW 84.34.020) and will continue in its current use? If yes and the transfer involves multiple parcels with different
Yes
classifications, complete the predominate use calculator (see instructions).
Date of Sale
AFFIDAVIT
I
certify
under
penalty
of
perjury
under the laws of the State of
0.00
Taxable Sale Price ............................................ $
Washington that the foregoing is true and correct.
0.00
Excise Tax: State........................................... $
Signature of
0.00
Local.......................................... $
Select Location
Seller/Agent
0.00
Delinquent Interest: State ............................... $
Name (print)
0.00
Local .............................. $
Delinquent Penalty ........................................... $

0.00

Date and Place of Signing:

Subtotal ............................................................ $

0.00

State Technology Fee ....................................... $

5.00

Signature of
Buyer/Agent

Affidavit Processing Fee................................... $

5.00

Name (print)

Total Due .......................................................... $

10.00

County Treasurer or Deputy

THIS SPACE - TREASURER’S USE ONLY
REV 84 0003e (02/28/23) DEPT. OF REVENUE

MOBILE HOME
REAL ESTATE EXCISE TAX AFFIDAVIT
Submit to County Treasurer of the county
in which property is located.

This form is your receipt when stamped by
cashier.
Used for Sales on or after March 1, 2023

Chapter 82.45 RCW
Chapter 458-61A WAC

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY
PLEASE TYPE OR PRINT
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY AND ACCURATELY COMPLETED.

Street
City

State

Zip code

Phone number
Name

Street
City

State

Zip code

NEW REGISTERED
OWNER (Buyer)

Name

LEGAL OWNER

LOCATION OF
MOBILE HOME

R E GI S T E R E D
OWNER (Seller)

Name

Street
City

City

LIST ASSESSED VALUE(S): $

SIZE

SERIAL NO. or I.D.

0.00

State........................................... $

0.00

Local.......................................... $

0.00
0.00
0.00

Name (print)

Delinquent Penalty ........................................... $

0.00

Date and Place of Signing:

Subtotal ............................................................ $

0.00

State Technology Fee ....................................... $

5.00

Signature of
Buyer/Agent

Affidavit Processing Fee................................... $

5.00

Name (print)

Total Due .......................................................... $

10.00

TREASURER’S CERTIFICATE
I hereby certify that property taxes due
County on the mobile home described hereon have been paid to and
including the year
.
Date

County Treasurer or Deputy

THIS SPACE - TREASURER’S USE ONLY
REV 84 0003e (02/28/23)

Yes

Signature of
Seller/Agent

Local .............................. $

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

REVENUE TAX
CODE NO.

AFFIDAVIT
I certify under penalty of perjury under the laws of the State of
Washington that the foregoing is true and correct.

Delinquent Interest: State ............................... $

If exemption claimed, WAC number & title:
WAC No. (Sec/Sub)
WAC Title

Zip code

Street

LIST ASSESSED VALUE(S): $

MODEL

State

Name

REAL PROPERTY
PARCEL or ACCOUNT NO.

YEAR

Zip code

Phone number

PERSONAL PROPERTY
PARCEL or ACCOUNT NO.

MAKE

State

COUNTY AUDITOR/ LICENSING AGENT

MOBILE HOME
REAL ESTATE EXCISE TAX AFFIDAVIT
This form is your receipt when stamped by
cashier.
Used for Sales on or after March 1, 2023.

Chapter 82.45 RCW
Chapter 458-61A WAC

Submit to County Treasurer of the county
in which property is located.

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY
PLEASE TYPE OR PRINT
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ARE FULLY AND ACCURATELY COMPLETED.

Street
City

State

Zip code

Phone number
Name

Street
City

State

Zip code

NEW REGISTERED
OWNER (Buyer)

Name

LEGAL OWNER

LOCATION OF
MOBILE HOME

R E GI S T E R E D
OWNER (Seller)

Name

Street
City

City

LIST ASSESSED VALUE(S): $

SIZE

SERIAL NO. or I.D.

0.00

Taxable Sale Price ............................................ $
Excise Tax:
Select Location

State........................................... $

0.00

Local.......................................... $

0.00
0.00

Local .............................. $
Delinquent Penalty ........................................... $

0.00

Date and Place of Signing:

Subtotal ............................................................ $

0.00

State Technology Fee ....................................... $

5.00

Signature of
Buyer/Agent

Affidavit Processing Fee................................... $

5.00

Name (print)

Total Due .......................................................... $

10.00

TREASURER’S CERTIFICATE
I hereby certify that property taxes due
County on the mobile home described hereon have been paid to and
including the year
.
Date

Name (print)

County Treasurer or Deputy

THIS SPACE - TREASURER’S USE ONLY
REV 84 0003e (02/28/23) TAXPAYER

Yes

Signature of
Seller/Agent

0.00

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

REVENUE TAX
CODE NO.

AFFIDAVIT
I certify under penalty of perjury under the laws of the State of
Washington that the foregoing is true and correct.

Delinquent Interest: State ............................... $

If exemption claimed, WAC number & title:
WAC No. (Sec/Sub)
WAC Title

Zip code

Street

LIST ASSESSED VALUE(S): $

MODEL

State

Name

REAL PROPERTY
PARCEL or ACCOUNT NO.

YEAR

Zip code

Phone number

PERSONAL PROPERTY
PARCEL or ACCOUNT NO.

MAKE

State

TAX LIABILITY
RCW 82.45.080 subjects the seller of real estate to the payment of the excise tax, and RCW 82.08.050 and 82.12.020 subjects the
buyer or user of personal property to the retail sales or use tax. Therefore, if the transfer is subject to the excise tax, it is the liability
of the seller and if the transfer is subject to the retail sales or use tax, it is the liability of the purchaser or user.
This affidavit must be fully and accurately completed. If it is not, the county has the authority to reject the affidavit. See
WAC 458-61A-303(6).
DEFINITION OF REAL ESTATE
A used mobile home is defined as real estate for purposes of this tax when the following conditions are met:
1. The mobile home was previously taxed by: (a) having been sold at retail and the retail sales tax has been paid
(Chapter 82.08 RCW), or (b) having been used, and the use tax has been paid (Chapter 82.12.RCW).
2. The mobile home has substantially lost its identity as a mobile unit by virtue of : (a) being fixed in location upon land owed
or leased by the owner of the mobile home, (b) being placed on a foundation (posts & blocks), and (c) having fixed pipe
connections with sewer, water, and other utilities.
TRANSFER SUBJECT TO EXCISE TAX
The transfer of a used mobile home will be subject to the real estate excise tax (Chapter 82.45 RCW) on the following transactions:
1. Transfers between individuals, and there is no requirement that the unit be moved.
2. Transfer from individual to dealer (trade-in), and there is no requirement that the unit be moved.
3. Transfer from a dealer to individual, and there is no requirement that the unit is to be moved. Dealer may be allowed credit on
the excise tax if unit was taken in trade, was not moved, and resale occurred within nine months.
TRANSFER SUBJECT TO THE RETAIL SALES OR USE TAX
The transfer of a new or used mobile home will be subject to the retail sales tax (Chapter 82.08 RCW) or use tax
(Chapter 82.12 RCW) on the following transactions:
1. Transfers between individuals when as part of the written agreement the unit is required to be moved.
2. Transfers of a mobile home upon which neither the retail sales tax, use tax, nor the real estate excise tax has been paid,
whether the unit is to be moved or not.
3. All transfers from a dealer’s sales lot.
CERTIFICATION OF TAXES PAID
The law requires that a copy of the excise tax affidavit and a copy of a treasurer’s certificate, stating that the property taxes have
been paid, be used as evidence of payment of the taxes. The Department of Licensing is prohibited from transferring or issuing a
certificate of ownership until it has verified that:
1. The excise tax on the sale, if due, has been paid, or the sales or use tax, if due, has been paid, and
2.

Any property taxes, whether real or personal, which are due on the mobile home have been paid.

LOCAL REAL ESTATE EXCISE TAX
Cities and/or counties are authorized to adopt by ordinance additional real estate excise tax to be collected and distributed by the
county treasurer (Chapter 82.46 RCW).
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)



State Technology Fee: A $5.00 Electronic Technology Fee is due on all transactions. (RCW 82.45.180)
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. (RCW 82.45.180)

AUDIT
All transactions are subject to audit by the Department of Revenue. An audit will confirm the proper amount of tax was paid and that
any claim for exemption is valid. Failure to provide documentation as requested may result in the denial of any exemptions claimed
and the assessment of additional tax with applicable interest and penalties. WAC 458-61A-301(9) 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 ruling on the taxability of the property transfer. Go to our website at dor.wa.gov/rulings or fax your request to
360-705-6655.
WHERE TO SEND COMPLETED FORMS:
Completed forms must be submitted to the County Treasurer’s or Record’s Office where the property is located.
To ask about the availability of this publication in an alternate format for the visually impaired, please call 360-705-6705. Teletype (TTY) users may use the
Washington Relay Service by calling 711.
REV 84 0003e (02/28/23)

Extracted from PDF file 2023-washington-rev-84-0003e.pdf, last modified December 2019

Download This Form

Print This Form

More about the Washington REV 84-0003e Other TY 2023

FOR USE WHEN TRANSFERRING TITLE TO MOBILE HOME ONLY

We last updated the Real Estate Excise Tax Mobile Home Affidavit in January 2024, so this is the latest version of REV 84-0003e, fully updated for tax year 2023. You can download or print current or past-year PDFs of REV 84-0003e directly from TaxFormFinder. You can print other Washington tax forms here.

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Related Washington Other Forms:

TaxFormFinder has an additional four Washington income tax forms that you may need, plus all federal income tax forms. These related forms may also be needed with the Washington REV 84-0003e.

Form Code	Form Name
REV 84-0002ea	Real Estate Excise Tax Supplemental Statement
REV 84-0001Be	Real Estate Excise Tax Controlling Interest Affidavit Tax Credit
REV 84-0001a	Real Estate Excise Tax Affidavit
REV 84-0005e1	Real Estate Excise Tax Statement of Taxes Collected
REV 84-0004e	Real Estate Excise Tax Refund Request
REV 84-0013	Real Estate Excise Tax Rates

Download all WA tax forms View all 5 Washington Income Tax Forms

Form Sources:

Washington usually releases forms for the current tax year between January and April. We last updated Washington REV 84-0003e from the Department of Revenue in January 2024.

Show Sources >

Historical Past-Year Versions of Washington REV 84-0003e

We have a total of five past-year versions of REV 84-0003e in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2023 REV 84-0003e

MOBILE HOME

2022 REV 84-0003e

MOBILE HOME

2021 REV 84-0003e

MOBILE HOME

2020 REV 84-0003e

Mobile Home Real Estate Excise Tax Affidavidt

2018 REV 84-0003e

Mobile Home Real Estate Excise Tax Affidavit

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Washington Real Estate Excise Tax Mobile Home Affidavit

Real Estate Excise Tax Mobile Home AffidavitMOBILE HOME

More about the Washington REV 84-0003e Other TY 2023

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Related Washington Other Forms:

Form Sources:

Historical Past-Year Versions of Washington REV 84-0003e

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Real Estate Excise Tax Mobile Home Affidavit
MOBILE HOME