Washington Real Estate Excise Tax Statement of Taxes Collected

Real Estate Excise Tax Statement of Taxes Collected
Statement of Taxes Collected Real Estate Excise Tax
REAL ESTATE EXCISE TAX
STATEMENT OF TAXES COLLECTED

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County ______________________________________________

Report Month/Year ______________________________________

Beginning Affidavit No. _________________________________

Ending Affidavit No. ______________________________________

Total No. of Affidavits __________________________________
(Including Mobile Homes)

Total No. of Mobile Home Affidavits _________________________

1. Total State & Local Tax Collected (Do not subtract tax refunded)
(Do not include: Refunds made, tax collected on mobile homes, and penalties and
interest) ......................................................................................................................

$

2. Total State and Local Tax on Mobile Homes ..............................................................

$
=

$

0.00

6. Less Lines 4, 5a, 5b and 5c ........................................................................................

-

$

0.00

7. Net State Tax Collected (Line 3 less line 6) ................................................................

=

$

0.00

8. Less Administrative Fee (1.3% from State Tax only, line 7) .....................................

-

$

9. Total Tax Being Remitted (Line 7 less line 8) .............................................................

=

$

10. Add total Delinquent Penalty collected .....................................................................

+

$

11. Add total State Delinquent Interest collected ............................................................

+

$

12. Add total $5.00 State Technology Fee collected.......................................................

+

$

12a. Less ½ of line 12 (retained by county for deposit to the special real
estate and property tax administration assistance account) ...............$ 0.00

-

3. Total of Lines 1 and 2 .................................................................................................
4. Refunds During Month ...........................................................

$

5.Local Tax Collected (County/City)
5a. Capital Projects ...........................................................

$

5b. Conservancy Land Acquisition & Maintenance ........

$

5c. Affordable Housing …………………………………....

$

13. Total to be returned to State Treasurer * (Add lines 9, 10, 11, 12, less 12a) ............

0.00

$

0.00

$

0.00

* If this item does not agree with the amount deposited with the State Treasurer’s Office on the monthly Cash Receipts Journal
Summary (State Form A8), list all adjustments which caused the difference below with explanation.
Adjustments:
Date _________________ Reason_____________________________________ (+)

= __________________________________

Date ________________ Reason ____________________________________ (-)

= __________________________________

14. Total Amount Remitted to the State Treasurer (Less adjustments) ..........................
List voided affidavits numbers:
____________________

_______________________
_______________________

$

_______________________
_______________________

0.00
________________________
________________________

or list a missing series: ____________________________ to _______________________________
Signature _______________________________________ Telephone ______________________________ Date ______________________
Distribution:

Original – Department of Revenue, attached to Affidavit Batch
Copy – State Treasurer’s Office, attached to monthly Cash Receipts Journal Summary
Copy – Retained by County Treasurer

For tax assistance, contact your local County Treasurer/Recorder or visit dor.wa.gov/reet. 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
WA Relay Service by
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REV 84 0005e1 (12/06/18) must complete this form, then print.