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2009, 09-01 Title Elimination•Froii:Montgomery Law Firm RETURN ADDRESS 509 684 2188 09/01/2009 10:43 #440 P.002/003 Montgomery Law Firm P.O. Box 269 CnlvillP, WA 99114-0269 File No. 4978 PLEASE CHECK ONE Manufactured Home rJ> NINOTON STAT[ D P**TYan IF IiiiTITLE ELIMINATION • LICENSING Application ❑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 40.12.210) D MANUFACTURED HOME TPO / PLATE NUMBER +336860 ,YEAR 2005 MAKE GRHIL I ENOTHAVIDTH(FEET) 52 X 27 VEHICLE IDENTIFICATION NUMBER (VIM 0RFL448A30105 2 LAND LEGAL DESCRIPTION ON PAGE MANUFACTURED HOME WILL RE IZAFFIXEO • REMOVED ea MU; TAX PARCEL NUMBER LOT 8 BLOCK 4 PLAT NAME OR SECTION/TOWNSHIP/RANGE Harrington's Addition QUARTER/QUARTER SECTION © GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADORIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS 1 NUMBER OF LEGAL OWNERS 1 NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER SAME AS LEGAL OWNER BELOW NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CRY STATE ZIP CODE NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER SCHAULS, DOROTHY 1. SCHAUD1636 NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 8718 East Harrington Avenue Spokane WA 99212 GRANTEE NAME 1 DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT 1 / WE AM/ARE THE REGISTERED OWNER(S) OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: Signature of Registered Owner and Title, IF APPLICABLE C. il- ler_ •4I s1 Aijai d. Signature of dltlonal Registered Owner and Title, IF APPLICABLE `�t1 .GA/'F�}� % NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S) SIGNATURE _;. Q` „,.��"\\\\ttlll 7 it, 1 State of Washington ( Signed or attested �} G �1',p19,� /// ( County of J� CNA s wt before me on l �� -� - •,,•, AR 10, '_7.. �Z ,-y7 s� 2� ~ /�r�lJ�S by /00,-c, t ic lti<� // Signature ! , U — PRIM NAME OF R GISTEREOOWNER NOTARY OR AGENT' Av by Bim\ Q ' A,= i OA PRINT NAME OF REGISTERED OWNER PRINTEO NAME OF NOTARY 1h 8- 14-.` �`C2� y County/Office No. OR S', '211,...11 I T�OEALtASHIPPOSITlOf444 �OTARY AND: ��� (v OF\ ArA.5��,- NotaryDeelreatipnDste 1 Exp Qi11 r ,x \'' TIl�i lPANY 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 / POemON DATE Finalize this application with a Licensing Agent within 10 calendar days of the dale Title Company Representative signs. 5 BUILDING PERMIT OFFICE CERTIFICATION I certify that: 0 the manufactured home has been affixed to the real property as described. iy'ga building permit has been Issued for this purpose and the attachment wil be Inspected upon completion_ E (TYPED OR PRI D) BLDG PPEERuMrT OFFICE/PHONE 11 CoBLDG Y�a i is Sll B-6 O 'MbC PERMIT r C/� lJ OOL7 e SIGNATURE/ PoSLmo� A Voir m,c• �►n0('\mak\a-- �i T ic)9 TD tH18/06) VPPaee