2000, 05-189 Title EliminationRETURN ADDRESS
Drummond and Ashenbrener, P.S.
140 S. Arthur, #600
Spokane, WA 99202
STATE OF W SHIGTON
N
4�t,_,�m..t II ANUFACTURED HOME
hansinG APPLICATION
TITLE ELIMINATION ❑ TRANSFER IN LOCATION ❑ REMOVAL FROM REAL PROPERTY
MANUFACTURED HOME
TPO / PLATE NUMBER
YEAR
MAKE
LENGTWWIDTH(FEET)
VEHICLE IDENTIFICATION NUMBER (VIN)
x
LAND ADDITIONAL LEGAL DESCRIPTION ON PAGE
TITLE FEES
MANUFACTURED HOME WILL BE q AFFIXED []REMOVED
PROPERTY TAX PARCEL NUMBER
FILING FEE
45134.2_I22 1
APPLICATION
LOTBLOCK
PLAT NAME
SECTION/TOWNSHIP/RANGE
22
2
ARMSTRONG E
MOBILE HOME FEE
A legal description can be obtained from the local County Assessor's Office. If there is not enough room here,
use the Application Attachment form, TD -420-732, available at your local County Auditor's Office.
ELIMINATION FEE
Lot 22, Block 2 of ARMSTRONG ESTATES as per plat thereof recorded
USE TAX
in Bolume 22 of plats, pages 64 and 65; Situate in the County
SUB -AGENT FEES
of Spokane, State of Washington.
TOTAL FEES & TAX
GRANTOR(S) REG!STERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY M
INCORPORATED UNINCORPORATED
M REGISTERED OWNERS
N LEGAL OWNERS
NAME OF FIRST REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
SAME AS RP.TCW
ADDRESS OF FIRST REGISTERED OWNER CITY STATE ZIP CODE
NAME OF FIRST LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
GLEI* A. HERSTEIN
ADDRESS OF FIRST LEGAL OWNER CITY STATE ZIP CODE
GRANTEES NAL NAMES ON PAGE
NAME OF FIRST GRANTEE DOL CUSTOMER ACCOUNT NUMBER
Anyone who knowingly makes a false statement of a material I DO SOLEMNLY ATTEST UNDER PENALTY OF PURJURY
fact is guilty of a felony, and upon conviction may be LAW THAT I / WE ARE THE REGISTERED OWNERS OF
punished by a fine, Imprisonment, or both. (RCW 46.12.210) THIS V§41CLE AND THIS INFOR ATION IS ACCURATE:
SIGNAT14URRE OF LEGAL OWNER INDICATES CONSENT FOR
✓`j
'E IMIN N F TITLE/ 13AMOVg ROM REAL PROPERTY:
SIGNATURE OF FIRST REG TEP15P OWNER AND TITLE, IF APPLICABLE
f i
SIGNATURE OF FLRVNERkAqD TITLE, IF APPLICABLE SI URE OF SECOND REGISTERED OWNER AND TITLE, IF APPLICABLE
NOTARY; OA $,SAMP.., it NOTARIZATION /CERTIFICATION FOR REGISTERED OWNER(S) SIGNATURE
f•; �y`4 yRFs �••• s II� Washington Signed or attested
Q` X111
i / County of �8 G before me
o ry �
,0
: ��
Signatur
�0', •:(}a `f'Printed Name of_Applicant
�•`,�g, s Dealer No. OR �/ ••
�Tde AND: County/OlficeNo. OR 7���3
.•.. o�
cSHIP Position/Agent/NOTARY Notary Expiration Date
DEALER'S REPORT OF SALE I certify that this information Is correct. The vehicle is clear of encumbrances except as shown.
DEALER NAME � p �l � � G ok ct,n
r
WA °EAI�EUMBER
1•{ (�
DATF—DFSALE
f [��
P.US HA§� I�,L, �t U
TAX JU SDICTION/TAX RATE`JDEALER'S
AUTHORIZED SIGNATUR
❑ USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized state ery).
COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Sub -Agents)
certiry that the above application appears to have been completed correctly, and the applicant has sufficient documentaFion to
proceed with the recording of this form.
NAME (TYPED OR PRINTED)
COUNTY OFFICENFS OPERATOR NUMBER
SIGNATURE
DATE
TD -420-729 MANUF HOME APPL (PJIM6)OR Page 1 of 2 INSTRUCTIONS AND ADDITIONAL INFORMATION ON REVERSE SIDE
TITLE COMPANY CERTIFICATION
I certify that the legal description of the land and ownership is true and correct per the real property records.
NAME TITLE COMPANY/PHONE NUMBER
SIGNATURE / POSITION
DATE
Finalize this application with a Licensing Aclent within 10 calendar days of the date Title Company Representative signs.
• BUILDING PERMIT OFFICE CERTIFICATION
I certify that the manufactured home has been affixed to the real property as described, OR a building permit he
purpose and the attent will be inspected upon completion
been issued for this
Nj1( ANE COUNWMITOFFICEIP
Pq
SIGJVSIBIDN LN L9
0 ✓
n �(
�vf / f)I
INSTRUCTIONS
COMPLETE THE APPROPRIATE BOXES ON THE FORM AS INDICATED BELOW,
DEPENDING UPON THE TRANSACTION YOU WISH TO PROCESS.
A. Manufactured Home Title Elimination Application (complete boxes 1, 2, 3, 4 and 6). Use to eliminate a title for a manufactured
home which is to become real property.
B. Manufactured Home Transfer In Location Application (complete all boxes). Use only when a manufactured home (whose
title has been eliminated) is being moved to land with a different legal description AND will become part of the real property to
which It will be moved and affixed. If the transfer in location is between two different counties, prepare this form in duplicate and
have each recorded in Its respective county.
C. Manufactured Home Removal From Real Property Application (complete boxes 1, 2, 3, 4 and 5). Use when titling a
manufactured home whose tide has been previously eliminated. Once properly completed and recorded, this application
becomes a supporting document along with others required to apply for a Certificate of Title for the manufactured home.
IMPORTANT: SIGNATURES OF THE OWNERS ON THE MANUFACTURED HOME APPLICATION INDICATE TERMINATION
OF INTEREST IN THE MANUFACTURED HOME THROUGH TITLE PROVIDED BY CHAPTER 46.12 RCW AND INDICATE
INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE LAND HE/SHE/THEY
OWN AND TO WHICH IT IS/WILL BE AFFIXED. IF THE MANUFACTURED HOME IS BEING REMOVED FROM REAL
PROPERTY, SIGNATURES OF THE OWNERS PER THE REAL PROPERTY RECORDS INDICATE CONSENT TO THE
REMOVAL. THE FORM MAY THEN BE USED FOR JJAKING APPLICATION FOR TITLE WITH THE DEPARTMENT OF
LICENSING AS PROVIDED BY CHAPTER 46.12 RCW.
Note: Owners of the manufactured home must own the land when the application is for a Manufactured Home Title
Elimination or a Manufactured Home Transfer In Location, as provided by Chapter 65.20 RCW.
SECTION 1 Enter the description of the manufactured home.
SECTION 2 Place an "X" in the appropriate box and enter the property tax parcel number, lot, block, plat number and
section/township/range; when applicable. Write a legal description in the space provided. If there is not enough room,
use the Title Application Attachment (TD0420-732). When processing a "Transfer in Location Application,' both boxes
should be checked. The application must then be accompanied by two separate land descriptions.
SECTION 3 This area must be signed by all registered owners of the manufactured home when processing a title elimination. If
the manufactured home has been sold and is being removed from the real property, the owners per the real
property records must complete this portion to obtain a Certificate of Title. Signatures of the owners must be
notarized or certified by the selling dealer or a vehicle licensing agent. Fees will include a filing and application
fee plus sales or use tax due. Additional fees may include: a title elimination fee and a Mobile Home Affairs Fee.
Subagents will charge an additional service fee. (Fees are subject to change without notice.)
SECTION 4 Take the properly completed Manufactured Home Application and all necessary supporting documents to the County
Auditor/Licensing Agent Office for approval. Supporting documents may Include but are not limited to: proof of
ownership or a Manufacturer's Statement of Origin (MSO), proof of taxes paid, and applicable release(s) of interest.
Subagents may not complete the approval portion of this form.
SECTION 5 The "Title Company Certification" box must be completed when processing a'Transfer In Location" or a "Removal
From Real Property" application. Important: The final recorded application form must be submitted to a vehicle
licensing agent within 10 days of the title company's certification.
SECTION 6 When processing an "Elimination" or 'Transfer In Location" application, a city or county office (depending upon the
location of the manufactured home) must certify that the home is affixed to the land;or, issue a building permit to affix
the manufactured home to the land, inspecting the completed attachment. The issuing office must sign the
application, adding the permit number if the inspection has not yet occurred.
IMPORTANT: Once the application has been approved by the County Auditor/Licensing Agent 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.
The Department of Licensing has a policy of providing equal access to Its services.
If you need special accommodation, please call (360) 902-3600 or TDD (360) 664-8885.
TD -420.729 MANUF HOME APPL (R/12/96)08 Page I of 2