1996, 01-30 Title Elimination01-603-475099-8
WoI s'uT TON
MANUFACTURED HOME RECORDER'S CLOCK FILED AT THE REQUEST OF:
41DSTp,Il�
rarfinenf
icEnsinc APPLICATION
NAME
ADDRESS
Please
X
check one
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)
1 MANUFACTURED HOME
TPO/PLATE NUMBER
YEAR
94
MAKE
MANSI
WIDTH/LENGTH
11 gA/p
VEHICLE IDENTIFICATION NUMBER (VIN)
VMHI2833W41476ABC
2 LAND
Attach a copy of the legal description of land. It can be obtained from County
your
Assessor's office or it may be typed or printed on an Additional
Manufactured home will be AFFIXED
your
Attachment Form (TD -420-732).
REMOVED
PROPERTY TAX PARCEL NUMBER
45134.2317
3 TITLE COMPANY CERTIFICATION
I certify that the legal description of the land and ownership is true and correct per the real property records.
NAME ITITLE COMPANY/PHOyFunucco ��•�••--••-
17 BLOCK 2 , ARMSTRONG FATES , ACCORDING 70 PLAT RECORDED IN VOLUME 22 OF
1
LlJT ,
F Ppf PAGES 64 AND 65, IN SPOKANE OlCtlu aays of the date Title Company Representative signs.
4 ....,wnvu rtHM!T OFFICE CERTIFICATION
I certify that the manufactured home has been affixed to the real property as described, or a building
perm' has been issued for this purpose and the attachment will be inspected upon completion.
G BLDG PERMIT #fi
.91f CCS 0 p If 9
NAME J�_
a FORMATIO
SIGNATURE/TITLE SPOKANE COUNT'
X DIVISION OF BUILDING AMID PL' i iiyIt'1n-:'
O/FFICE/PH�ON/E U
BLDG PER TLA---6_6(„
(Tei !�� _ X075
DATE /� / /� /
1 ll r%� 7[A
OW R INFORMATION
FEES
COUNTY # INC UNINC
❑ 1
# REGI FRED 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 JERRY R ARMSTRONG (AKA: J R ARMSTRONG)
(,O)L Aii2iviST5W,e,31.5
APPLICATION
I
G NAME OF SECOND OWNER
1
s GLENDA L ARMSTRONG
EADDRESS
LV AiZMST(�LL O`'MG.
MOBILE HOME FEES
I
E OF OWNER
R PO BOX 10
E
--OR-- if the owner is a business,
ELIMINATION
I
D CITY
VERADALE,
STATE
WA
ZIP CODE
99037-0010
provide the Unified Business
Identifier (UBI), found on the
business Registration & Licenses
USE TAX
NAME OF FIRST LEGAL OWNER'
LWASHINGTON MUTUAL BANK
I
e
Document.
578049326-7
SUB -AGENT FEES
MAILING ADDRESS OF FIRST LEGAL
x E 12005 SPRAGUE
o
OWNER
AVE, 2ND FLOOR
More than two owners or one
lienholder? Please use attachment
TOTAL FEES & TAX
L CITY
D SPOKANE
TATE
ZIP CODE
form(s) #TD -420-732.
E
WA
99216
DEALER'S REPORT OF SALE
R *SIGNATURE OF LEGAL OWNER
FROM REAL PROPERTY: X
CA S
SEN F
R E INATION OF TITLE/REMO AL
�7 _
/ 76 //a�
I certify that this information is correct. h e
of encumbrances except as shown.
1 l is clear
Anyone who knowingly makes a false
upon conviction may be punished by a
(RCW 46.12.210). I DO SOLEMNLY
e nt of a ma 1 fact is guilty of a felony, and
fine of up to $5,000 and/or 10 years imprisonment
ATTEST UNDER PENALTY OF PERJURY
WA DLR NO.
DATE OF SALE
PURCHICE
$7t GtX) 1
J
LAW
THAT I/WE ARE THE REGISTERED OWNERS OFTHAG ,F,I1ND THIS INFORMA-
TION ISA CURATE: ner Slgneture(s) & Title _ T "'-re,
v Ti
DEALER NAME
TAX 1URI�DICTION/TAX RATE
�i '. 4"-
' ,...,., ; �� \ ^ 'a�,
X i� ' 0,\I (
DEALER'S AUTHORIZED SIGNATURE
. \
`4A
7- '47-27 /%t' 1171'
'
_ t-, 1- /? y , ; ;
X ' ^ • + ;
USE TAX EXEMPT Sale to a Certified Tribal member on
the reservation (attach notarized statement of delivery)
NOTARY OR LICENSE AGENT & NUMBER p ti n
i (SUB'SSCRIBED p AND WON BEFORE ME THIS
Residing in (County)
••
..:-.3..)A,OF
P--- ' /I _...;'
—°• 19
6 COUNTY AUDITOR/A c447%%:rl v' ;t:�ir1: O• FFICt.A'PP);1Q1/AL: (Not for u by Sub -Agents)
•1
certify that the above applicatio tipear�;to ttav rfeen complet corr , - nd t " ' ..licant has sufficient documentation to
proceed with the recording of this form ,-.-.•,;--.-- ,p" = •'
NAME
SIGNATURE +;•'- -'
X
0 I ,: ,,:;fPERATORNUMBER
DATE
-420-729 MANUF HOME APPL (R/2 94)M Page 1 of 2