1999, 12-03 Title EliminationRETURN ADDRESS
Attn: Sandy
Custom Closing & Escrow
1500 West Fourth Avenue, Suite 511
Spokane, WA 99204
99101264 - FURY - Refinance
E7 STATF. Or WASIfINGTON MANUFACTURED HOME '
L4� Drym.j g", nJ ,
APPLICATION IRITITLE ELIMINATION
ftCEn.5jn(W ❑TRANSFER IN LOCATION
Anyone who knowingly makes a false statement of a material fact is guilty ❑REMOVAL FROM REAL PROPERTY
of a felony, and upon.conviction may be punished by a fine, imprisonment, or both. (RCW 46.12.210)
MANUFACTURED HOME 4
TPO / PLATE NUMBER
YEAR
MAKE
LENGTHANIDTH(FEET)
VEHICLE IDENTIFICATION NUMBER (VIN)
@1564
1 1967
VANDK
I 64X 12
1 287q
LAND LEGAL DESCRIPTION ON PAGE
MANUFACTURED HOME WILL BE ®AFFIXED ❑
REAL PROPERTY TAX PARCEL NUMBERREMOVED 55064.0908
LOT 8
BLOCK 8
PLAT NAMEDONWOOD EAST SUBDIVIS
SONON/TOWNSHIP/RANGE
El GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY NUMBER
NUMBER OF REGISTERED OWNERS
NUMBER OF LEGAL OWNERS
NAME OF REGISTERED OWNER -
Thomas L. Fur
NAME OF ADDITIONAL REGISTERED OWNER
Bernice A. Fur
ADDRESS CITY STATE ZIP CODE
18308 East Dalton Avenue
NAME OF LEGAL OWNER
Metropolitan Financia
NAME OF ADDITIONAL LEGAL OWNER
601 West First Avenue
ADDRESS CITY STATE ZIP CODE
Spokane, WA 99201
GRANTEE
NAME
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I /WE AM/ARE E REGISTERED OWNE S) OF THIS
VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title, IF APPLICABLE��
Signature of Addn.ibhahqqgistered Owner and Title, IF APPLICABLE /
NOjjA k3 AL SjVP t t' NOTARIZATION/CERTIFICATION F R REGISTERED OWNER(S) SIGN RE
, y fi State of Washington Signed or attested
County of before me on if
•� i0e� •
;• A � Thomas L. Fury Signatur •0 C�YlI/LC�L/
PRINT NAME OF REGISTERED OWN NOTARY OR ENT
=
4y �lTY-l/fiV M •
Bernice A . Fury
• �f. f ,, �� PRINT NAME OF REGISTERED OWNER PRINTED NAM OF NOTARY
A zf�NN'Ki4 County/Office No. OR
r�.•�t I Title l AND: Dealer No'
DEALERSHIP POSITIO /AGENT/NOTARY Notary Expiration Date
TITLE COMPANY CERTIFICATION
I certify that the legal description of the land and ownership is true and correct per the real property records.
NAME (TYPED OR PRINTED) TITLE COMPANY/ PHONE NUMBER
SIGNATURE / POSITION DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
BUILDING PERMIT OFFICE CERTIFICATION
I Certify that: Z the manufactured home has been affixed to the real property as described.
❑ a building permit has been issued for this purpose and the attachment will be inspected upon completion.
NAME (TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE N BLDG PERMIT 4
,-
SIGNATURE / POSITIO DATE
( 1 -
0--)
=<Dkl�l 9—)
TD -420.729 MNUF OME APPL (R/8/90)OR Page t o12' Ll
V alulvw f <)tit U►- LtGAL OWNER
SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE/ REMOVAL FROM REAL PROPERTY.
Signature of Legal Owner and Title, IF APPLICABLE uz 'FIS)OZ&D,
Signature of Additional Legal Owner and Title, IF APPLICABLE
Nil's I NOTARIZATION/CERTIFICATION FOR LEGAL OWNER(S) SIGNATURE
G,Q % State of Washington
Signed or attested
yA i County of ��' �,,Z dz
v before me on
qb IIS tropolitan Financial C}pr Z(--�
,pUBLfCNAME OF LEGAL OWNERtTaTllTe
NOTARY OR AGENT
PRINT NAME OF LEGAL OWNER
yvASH�NC,PRINTED NAME OF NOTARY
Title /V0 County/Office No. OR
DEALERSHIP POST ON/AGENT/NOTARY AND: Dealer No. OR 5' 3
ary
LAND DESCRIPTION (A legal description of the land can be obtained from the local County Assessors Office
Lot 8 in Block 8. Of DONWOOD EAST SUBDIVISION, as per
thereof recorded in Volume 10 of Plats, Page 87; plat
Situate in the County of Spokane, State Of Washington.
DEALER'S REPORT OF SALE
i CERTIFY THAT THIS INFORMATION IS CORRECT. THE VEHICLE IS CLEAR OF ENCUMBRANCES EXCEPT AS SHOWN.
ANY REQUIRED SALES TAX HAS BEEN COLLECTED.
DEALER NAME (TYPED OR PRINTED)
WA DEALER NUMBER DATE of SALE
PURCHASE PRICETAX JURISDICTION/TAX RATE I DEALER'S AUTHORIZED SIGNATURE
❑ USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery).
COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Subagents)
I certify that the above application appears to have been completed correctly, and the applicant has sufficient documentation to proceed with
the recording of this form.
NAME (TYPED OR PRINTED)
COUNTY OFFICEN OPERATOR NUMBER
SIGNATURE '
DATE
TITLE FEES
FILING FEE APPLICATION
MOBILE HOME FEE ELIMINATION FEE
USE TAX SUBAGENT FEES
TOTAL FEES & TAX
IMPORTANT:
Once the application has been approved by the County Auditor/ Vehicle
Licensing Office, take your application form to the County Recording Office.
Retain proof of the recording fees paid. If the Recording Office retains
your original application form, obtain a certified copy of the recorded form.
APPLICANTS: Once recorded, you must return to a Vehicle Licensing office to file the
Manufactured Home Application, paying all required fees. Vehicle
licensing subagents charge a service fee.
For full instructions on completing this form foffitle Elimination, Removal from Real Property
or Transfer in Location, see form TD -420-730, Manufactured Home Application Instructions.
The Department of Licensing has a policy providing equal accss to its
% you need special accommodation, please/ al (360) 902-3600 ore
TDD (360) 6,64 8885.
TD -420.729 MANUF HOME APPL (R/a/98)OR Page 2 of 2