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2007, 11-09 Title Elimination
C RETURN ADDRESS Carl Hockhalter and Sandra Hockhalter TRANSNATION NORTH 503 W. FRANCIS SPOKANE, WA 99205 STATE OF MANUFACTURED HOME PLEASE CHECK ONE WASHINGTON Department of Licensing APPLICATION '6k TITLE ELIMINATION Escrow No. 20326297-506-BCB 0 TRANSFER IN LOCATION 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. 0 REMOVAL FROM REAL PROPERTY RCW 46.12.210) MANUFACTURED HOME TPO/PLATE NUMBER 1Y4Ag 3 `j Aai_E. l,E� XTH/ /171 (FEET) / ttIC1 1 IDFNTIfICAATI3O N 0 OBER VIN) `/ 2 LAND LEGAL DEStCRIPTIION ON PAGE MANUFACTURED HOME WILL BE o AFFIXED o REMOVED REAL PROPERTY TAX PARCEL NUMBER 55192.1813 LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE QUARTER/QUARTER SECTION 3 GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE _ COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS NAME OF REGISTEREDIOWNER DOL CUSTOMER ACCOUNT NUMBER C{�P- L [ oc k._ km /f"�r 14oKN C_..../- .5-Q- / 6.7 NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER saOpleRi Ho -k kra1±e, Hy<pc.kHSL ��G/3 .2-- ADDRESSZIP CODE ov 3 '7 Co 1L 1 I < � ASTATE 99 0 O,7 NAME OF REGISTERED LEGAL OWNERDOL CUSTOMER ACCOUNT NUMBER S fl rn -e. f\ S A tff oo ./ NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT AM/ E E - GIS ER O •S) OF THIS VEHICLE AND THE INFORMATION IS ACCURATE:ly/� / Qit�> Signature of Registered Owner and Title, IF APPLICABLE y Signature of Additional Registered Owner and Title, IF APPLICABLE �y�` >� . '��'�—_ N©T•At3Y-9-EAt: ®R-S'FAMP B. C. BERN EIS OTARIZATION/CERTIFICATIO1FOR REGISTERED OWNER(S) SIGNATURE tate of Washington Signed or attested p / /v ., County 4f / �2� before me on TATE OF W/� HII�:�TO NOTARY --0-- POLIO yCO�L fioc k/1 Q 1-e- r' J�� Signature )/' `mac c �— PITY COMMISS!ON E (PIRES M•G9•(n P INT NAME OF RE9IST D OWNER {� TARY OR AGENT Y AN D R E I- . t- �c K/2 A/ re r IJ c Q !� /1�) r PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY r. County Office No. OR TITLE PZ.;: -1....7 C �� AND: Dealer No. OR S/' �/� DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date 4 TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME (TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. 1111 BUILDING PERMIT OFFICE CERTIFICATION 0 the manufactured home has been affixed to the real property as described. •.1 certify that:: 0 a building permit has been Issued for this purpose and the attachment will be Inspected upon 4 completion. NAME (TYPED OR PRINTED) kik cl`AcK. i- BLDG PERMIT OFFICE/PHONE # -` U�� -CMZ 03 BLDG PERMIT # `_1. �` 0 ;sr NA RE/P TION /+ DATE