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1995, 11-27 Title Elimination♦UINCTON MANUFACTURED HC / ,ensinc APPLICATION /jhockone RECORDER'S CLOCK FILED AT THE REOUEST OF: NAME ADDRESS 1 TITLE ELIMINATION (Complete all but section 3, below) TRANSFER IN LOCATION (Complete ALL sections below) REMOVAL FROM REAL PROPERTY (Complete all but section 4, below) 111 MANUFACTURED HOME TPO/PLATE NUMBER YEAR 1982 MAKE BUDDY SKYLINE WIDTH/LENGTH VEHICLE IDENTIFICATION NUMBER (VIN) 0496-0253—BA iEi LAND Attach the legal description of land. It can be obtained from County a copy of Assessor's office or it may be typed or Manufactured home be your printed your on an Additional Attachment Form (TD -420-732). AFFIXED REMOVED PROPERTY TAX PARCEL NUMBER 55181.3829 will x © TITLE CC dPANY CERTIFICATION I certify that t le legal description of the land and ownership is true and correct per the real property records. NAME TITLE COMPANY/PHONE NUMBER SIGNATURE X DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 3 BUILDING PERMIT OFFICE CERTIFICATION I certify that the manufactured home has been per it has been issued for this purpose and affixed to the real property as described, or a building the attachment will be inspected upon completion. BLDG PERMIT# 5 �A - 106)R NAM 1 f �_ 1`/ IO ( SIGNATUREmTLE X nIVISION SPOKANE COUNTY BLDG PERMIT OFFICE/PHONE 1 OF BUILDING ANp PLANN t4c isnot) /.152.- •R�r7c� �J J DATE /`,� J G} `p I 5 OW ER /NFORMATIO FEES COUNTY 1 INC UNINC ❑I XI 1 REGI TERED OWNERS 2 1 LEGAL OWNERS 1 Provide the Washington Driver's License or I.D. card number (PIC) for each owner: FILING FEE NAME OF FIRST OWNER R E GARY .M HOPKINS < 4 p/Fire 111yix_ APPLICATION O NAME OF SECOND OWNER s LAURIE J HOPKINS T 1 N)X / L -J1/ 7 V 0 .3 MOBILE HOME FEES E ADDRESS OF OWNER R1306 N LONG RD --OR-- if the owner is a business, Unified Business ELIMINATION 0 CITY GREENACRES STATE WA ZIP CODE 99016 provide the Identifier (UBI), found on the business Registration & Licenses USE TAX k 1 NAME OF FIRST LEGAL OWNER' WASHINGTON MUTUAL BANK Document. 578049326-7 SUB -AGENT FEES IE N n MAILING ADDRESS OF FIRST LEGAL OWNER 12005 E SPRAGUE AVE SECOND FLOOR More than two owners or one lienholder? Please use attachment TOTAL FEES & TAX LCITY STATE ZIP CODE form(s) #TD -420-732. $ o A'SIGNATURE SPOKANE WA 99206 DEALER'S REPORT OF SALE OF LEGAL OWNER IN ,ATES CONSr FROM REAL PROPERTY: X .6"-e."--12, R EI A OF TITLE/REMOVAL I certify that this information is correct. The vehicle is clear of encumbrances except as shown. Anyone who knowingly makes a false statement of a materi upon conviction may be punished by a fine of up to $5,000 and/or (RCW 46.12.210). I DO SOLEMNLY ATTEST UNDER PENALTY THAT I/W ARE THE REGISTERED OWN •S OF THI EHICLE TIONIS C URATE: Owner Signa / & Title X I ►. IS / . ��/0 '. fact is guilty of a felony, and 10 years imprisonment OF PERJURY LAW AND THIS INFORMA- WA DLR NO. DATE OF SALE PURCHASE PRICE DEALER NAME TAX JURISDICTION TAx RATE DEALER'S AUTHORIZED SIGNATURE �„� ---,,.� y ,v• I 1...o( .1� �: % WO X ���� USE TAX EXEMPT Sale to a;rernfi d T ibb:rmember,op - the reservation (attach notarized statement of cla)ivery) X NO Y 0 LICEf/NSE'AGENT & N MBER ({ Q� X �„c�-r1 ),-4 @�.r _L SUBSCRIBED TO ANthSWORN BEFORE ME THIS ai DAY OF-_� '�(�.,c __19 CLS-- Residing in (Co ) ,y1� . ' .. ; f C\+ /_0,,, t • if. 1 6 COUNTOAUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Sub -Agents) ,, '' l I certify that the above application appears to have been completed cor - ..,,, , proceed with the recording of this form. . the - ' ant has sufficient doour? t*onfo NAME SIGNATURE o, X FFICE S OPERATOR NUMBER ,.'. '.,,.. es, 4tw1 DATfi ' p„.fir �...._ 1420-729 MANUF HOME APPL (R/2/94)M Page 1 of 2