1996, 09-03 Title EliminationPlease
XX
check one 01-603-597142-9
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)
'SEP 0 ,a .Its>'4
II2005 SGTO N fTf1AL
12U05 SPRAGUE AVE
/S OKANE, WA 99206-5
1 MANUFACTURED HOME
TPO/PLATE NUMBER
YEAR
��//J
/M/A E7J]. i
/
�7
WIDTH/LENGTH
'()//'' (X 7 %
VEHICLE IDENTIFICATIONNUMBERj/VJN') .
C.,c. F L r 4-19 ,S :Z.1:2) : yG - c -X-7 13
2 LAND
Attach a copy of the legal description land. It be from County
of
Assessor's office or it may be typed or
Manufactured home will be
your can
printed on an Additional
obtained your
Attachment Form (TD -420-732).
REMOVED
PROPERTY TAX PARCEL NUMBER
55182.0355
iLkAFFIXED
3 TITLE COMPANY CERTIFICATION see attached legal
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
X
DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
4 BUILDING PERMIT OFFICE CERTIFICATION
I certify that the manufactured home has been affixed to the real property as described, or a building
permit has been issued for this purpose and the attachment will be inspected upon completion.
BLD PERMIT#
6 l�ii()Z 7 '.37J
NAME
\ \SCI I t4 ___
SIGNATURE/TITLE
X SPOKANE COUNTY PERMIT CENTER
BLDG PERMIT OFFICE/PHONE #
UtC-c-,-F_..`-kc:
DATE
\\\\Q*,
5 OW R INFO'?MATION
FEES
COUNTY# INC UNINC
1 1 ❑
# REGISTERED OWNERS
2
# LEGAL OWNERS
1
Provide the Washington Driver's License or I.D.
card number (PIC) for each owner:
FILING FEE
NAME OF FIRST OWNER
E RICHARD J HARMON
k7l n K 1.46 K 3 c,---(-7 t S
APPLICATION
G NAME OF SECOND OWNER
1
T I ARLENE HARMON
f-i..il.K M y 011\ ,o 5 c 8
MOBILE HOME FEES
E ADDRESS OF OWNER
R 17610 E MISSION AVE
E
--OR-- if the owner is a business,
ELIMINATION
D CITY
GREENACRES, WA
STATE
WA
ZIP CODE
99016
provide the Unified Business
Identifier (UBI), found on the
business Registration & Licenses
USE TAX
NAME OF FIRST LEGAL OWNER'
L.
WASHINGTON MUTUAL BANK
Document.
5780493267
SUB -AGENT FEES
NMAILING ADDRESS OF FIRST LEGAL OWNER
H E 12005 SPRAGUE AVE, 2ND FLOOR
More than two owners or one
lienholder? Please use attachment
TOTAL FEES & TAX
LCITY
STATE -
ZIP CODE
form(s) #TD -420-732.
$
D SPOKANE
E
WA lR
,f
99206
EALER'S REPORT OF SALE
R *SIGNATURE OF LEGAL OWNER DIC�IATESCONSENT R E IMINA ON
FROM REAL PROPERTY: X! (�/ (�1 .-{`
OF TITLE/REMOVAL
"q�'>>�' 47
I rtify that this information is correct. The vehicle is clear
encumbrances except as shown.
Anyone who knowingly makes a false statement o`f almeten %,, }}f }}f ,, . isI
upon conviction may be punished by a fine of up to $5,000 an¢>'br AV, pns ,
(RCW 46.12.210). I DO SOLEMNLY ATTEST UNDER PELT PERJURY
DLR NO.
j,, It q / o'
I
DATE OF SALE
g-- ZZ -'3
PURCHASE PRICE
$ 5'13501 1-�
i'•
THATI/WE ARE THE REGISTERED OWNERS OF THIS VEICLP4Dili-TIADR cP�EALVNAME
TION I CURATE: Owner Si nature s) a Title(s): - `` /
X.... ,ti.G(�. - / t. i(4yL tAcn;. U8fL1
L'
- �, 0e !h r 1 •f�f Z�,.y� > 5
TAX JURISDIcri RATE
'S .
f ALE i'S AUTHORI ED S - •
•
//i
o;`�s
X C.Gt �� f Ya l.4- r z„, 1-L' %.37A4/ �7 r�p0��
fl``'�Ce;..
USE TAX EXEMPT Sale to a Certified Tribal member on
the reservation (attach notarized statement of delivery)
,,r 0 ,
X 11� �� SIA sr. —
NO • s R LICENSE krAEN.\T\B!NdM`B1EY� ' !fir`
.d a'i 9CJ r/ ' `/��\/v VQ' _ \
SUB .L WORN BEFOR ME THIS /
a DAY OF ti _ Vl 197 l!/
Re ' 'gin (C unty)
may,
6 COUNTY LICENSING OFFICE APPROVAL: (Not fo-rilluse by Sub -Agents)
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
SIGNATURE
X
OFFICENFS OPERATOR NUMBER
DATE
-420-729 MANUF HOME APPL (R/2/94)M Page t of 2