Loading...
2013, 10-01 Title EliminationRETURN RECORDED DOCUMENT TO: Inland Professional Title 25 W. Cataldo, Ste B Spokane, WA 99201 dtWASHINGTON STATE DEPARTMENT OF i LICENSING Manufactured Home Application For full instructions on completing this form, see Manufactured Home Application -420-730. Please check one: IZTitle Elimination DTransfer in Location 0 Removal from Real Property 1 Manufactured Home TPO/Plate number +077323 Year 1995 Make GRENH Length/Width (feet) 56 x 28 Vehicle identification number (VIN) ORFLS48A20664GH13 2 Land Manufactured FA home will be Affixed ❑ Removed Real property 45031.4706 Legal description on page 2 Tax parcel no Lot C Block Plat name or Section/Township/Range Alters Final Short Plat 11-92 Quarter/Quarter section 3 Grantor(s) Registered/Legal Owner(s) — Additional names on page County number No. registered owners 1 No. legal owners Grantee name (if applicable) Name of registered owner Estate of Donna J. Pope Washington driver license or UBI number Name of additional registered owner Washington driver license or UBI number Address (Address, City, State, ZIP code) 2324 S University Road, Spokane Valley, WA 99206 Name of legal owner Same Washington driver license or UBI number Name of additional legal owner Washington driver license or UBI number Address (Address, City State, ZIP code) I declare under penalty of perjury under the laws of the state of Washington that I am/we are the registered owner(s) of this manufactured home and the foregoing information is true and correct. 1) TD -420-729 (R/4/12)WA Page 1 of 3 NL catbA0 Signature egi a ed owner a d tttl�`tif apppllicable Signature of additional registered owner�and title, if applicable State of LOR5'4 & X O County of a . ON,C_PY(\_) 2 Signed or attested before me on © �e31 by KAeD1v le.. VAc b►JCELO by .---PrfN registered owner name Pr' egis re owner �Nr;11,04 UB-1/•�l, q (LA, 2.. Notary printed or stamped name Notaryignat re kM5 VA and signature Title Dealer/county office number or notary expiration Continued on next page 00 1 IvIIuula{.1u1 c4 ..v... • • .... .-..� ......---- ..----- - - - 4 Title Company Certification Title company name PRINT or TYPE Name of person signing Position (Area code) Telephone number I certify that the legal description of the land and ownership is true and correct according to the real property records. X Signature Date 5 Building Permit Office Certification 1 c ify that 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. PRINT or TYPE Name of person signing PkIeWk L 'w(-4 aA-lc Building permit office C -SV Building per it number m14- 950003(0 Posit eV. J S 6 364 )41A --NY (Area code) Telephone number ' 7 Signature Date 6 Signature of Legal Owner(s) Signature of legal owner indicates consent for Elimination of Title or Removal from real property. , I X'-(91Ailek-ept. b t % \`0\t11111111/110 SignatureMega!^ownnerra�titl if a• able N E i'%, X K� liid .�`\\•\rPN i i, ,;` J :sslon F .••se.,./, -.! Signature of additional legal owner and title, if applicable CCN V; State of i`JTS?�\i,X�rDt�,Countyof 5 �£- - j ,,\ OMR UB _= Signed or attested before ... -\ by S E\IWOL) V'. me on 00---T06€12- l i aD i3 V4ScoluC_w�,y %N�...96,UBII 5.• � 9›•6. •• •• •' 1 p-20.. c; ��� registered owner name int r ist red owner uL2. � P7-170 OF %o 2i/ WASH\ `\''Notary printed stamped nameC. r.nlrlll\\\t\-X:11-ThE`( and ?TUp tary rl©ilS Title Dealer/county office number or notary expiration 7 Land Description Legal description of land Lot c, Altered Final Short Plat 11-92, as per plat recorded in Volume 9 of Short Plats, Pages 90 and 91, records of Spokane County; Situate in the City of Spokane Valley, County of Spokane, State of Washington. TD -420-729 (R/4/12)WA Page 2 of 3 Continued on next page Manufactured homeTPO/Plate number (from Section 1) 4 Title Company Certification PRINT or TYPE Name of person signing Title company name Position (Area code) Telephone number I certify that the legal description of the land and ownership is true and correct according to the real property records. X Signature Date 5 Building Permit Office Certification I certify that ❑ 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. PRINT or TYPE ame of person lit, tG signing Buildi e t office Buildin permit• umber � 0 - `1S 00 oto F1�4 Po ' ioo e) Tele hone numb % ' SVL'S C;pQ:��jlw�''�O(Area c �C .1ZO, 1 / X lik ---CisA-(, /et iti►3 Signature Date 6 Signature of Legal Owner(s) Signature of legal owner \\0011111111/W0 ,s ,\\':?... NF y/ ,.• \SSion �.• (e U NOTAL y m' PUBLIC_- %N9� . ./0-20�5•'.\°�''. �///�� WA�`\G ��`�\ ,/// I i i i 1111111\��� indicates consent for Elimination of Title or Removalvfrom real property. X etA.-vN - V pa c b i ;T--e11Abv\e& Signature <,� x, of legal owner and title, if applicable C6-1kAe, __- �Qo �, Signc ure of additional legal owner d title, if applicable _ State of SffMA:73A) County of 6POK%DE Signed or attested before by Srlilt'DRJ k Vf15'C©NC£L.E)S , me on OC r ` B2;2 /, by f're�Ner %e G cJ'ist e o ame Notary printed or stamped name Uptary signature and Title Dealer/county office number or notary expiration 7 Land Description Legal description of land Lot c, Altered Final Short Plat 11-92, as per plat recorded in Volume 9 of Short Plats, Pages 90 and 91, records of Spokane County; Situate in the City of Spokane Valley, County of Spokane, State of Washington. TD -420-729 (R/4/12)WA Page 2 of 3 Continued on next page M f tured home.TPO/Plate number (from Section 1) anu ac 8 Dealer Report of Sale — Selling dealer complete this section PRINT or TYPE Dealer name Washington dealer number Date of sale Purchase price Tax jurisdiction/Tax rate ❑ Sales Tax Exempt — Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery). I certify that this information is correct. Any required sales tax has been collected. The manufactured home is clear of encumbrances except as shown. X Dealer authorized signature 9 County Auditor/Agent Licensing Office Approval (not for use by subagents) PRINT or TYPE Name County office/VFS operator number I certify that the above application appears documentation to proceed with the recording to be completed correctly, and the applicant has sufficient of this form. X Signature Date 10 Title Fees Filing fee Application Mobile home fee Elimination fee Use tax Subagent fees Total fees and tax $ 0.00 Anyone who knowingly makes a false statement of a material fact is guilty of a felony, and upon conviction may be punished by a fine, imprisonment, or both. RCW 46.12.750 We are committed to providing equal access to our services. TD -420-729 (R/4/12)WA Page 3 of 3 If you need accommodation, please call (360) 902-3600 or TTY (360) 664-0116.