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Accessory Dwelling Unit Certification of Owner Occupancy State of Washington ) County of King S/S ) I, , being first duly sworn, on oath do hereby certify under penalty of perjury under the laws of the State of Washington: That I am an owner of the single family dwelling unit located at and have a fifty percent(50%)or greater interest in this property; and That I have applied or am making application to establish an authorized accessory dwelling unit at this location; and: ❑ That I presently occupy and will continue to occupy one of the two dwelling units at this location as my principal and permanent residence(see Land Use Code Section 23.44.041A2). ❑ That this certification will remain in effect during the period of my ownership of the property unless I re- cord a certification with the King County Office of Records and Elections that the use of the property for an accessory dwelling unit has been discontinued. ❑ That I am building a new single family residence with an accessory dwelling unit with the intent to sell the residence. When the property is sold, I will notify the new property owner(s)of the requirements of SMC 23.44.041, includ- ing the requirement to file a new Certification of Owner Occupancy with the Department of Planning and Devel- opment(DPD)for recording if they intend to maintain and rent the accessory dwelling unit. Failure to submit this certification within one year of transfer of ownership shall be a violation of the Land Use Code if the new owners continue renting the accessory dwelling unit. This certification will remain in effect during the period of my ownership of the property unless I record a certifi- cation with the King County Office of Records and Elections that the use of the property for an accessory dwell- ing unit has been discontinued. (SEAL OR STAMP) Signature of Affiant Name of Affiant Signed and sworn to(or affirmed)before me on this day of (month), (year)by Signature of Notary Public Title My appointment expires: Falsely certifying owner occupancy or failing to comply with the terms of owner occupancy certification is subject to a civil penalty of$5,000, in addition to any criminal penalties. A recording fee must be paid to the Department of Planning and Development for the purpose of recording this document with King County.