To: Walla Walla County Assessor

To: Walla Walla County Assessor

315 W Main Street

Walla Walla WA 99362

Attn: Segregation Department

Phone (509) 524-2560 or 524-2573

Please Print:

From:______

______

______

Daytime Phone # ______

Contact Person ______

Contact Phone # ______

Parcel Numbers ______

______

______

FOR AREAS IN BOLD TYPE & UNDERLINED PLEASE CIRCLE ONE ONLY

I am the owner/other (if other please explain)______of the above mentioned tax parcels and I am requesting a segregation/combination of the legal description of the above tax parcel(s) per the recently recorded Survey/Short Plat/Plat/Deed/Other.

There are buildings/no buildings located on this property. If there are buildings please show where they are located by attaching a map or sketch.

Please provide acreage/square footage of portion being segregated. ______

Additional information that may be helpful in complying with your request:

Date______Signature______

**Please note: Property taxes, including applicable irrigation district taxes, must be PAID IN FULL for the year in which the property is being segregated/combined per RCW 84.56.340