1996, 04-08 Title EliminationL}795TAT£ortvnsNINGTOY. MANUFACTURED HOME
�f Dtporl�n�n1 of
' icEnsinc APPLICATION
RECORDER'SCLOt.'
FILED AT THE REQUEST OF:
NAME
Please
—D.
check one
TITLE EUMINAT1ON (Complete all but section 3, below)
TRANSFER IN LOCATION (Complete ALL sections below)
REMOVAL FROM REAL PROPERTY (Complete all but section 4, below)
ADDRESS
1 MANUFACTURED HOME
TPO/PLATE NUMBER
&047219
YEAR
1994
MAKE SKYLINE
SNOODFIELD
WIDTH/LENGTH
28 X Mfr 60
VEHICLE IDENTIFICATION NUMBER (VIN)
17 -91 -Q625 -G -AB
2 LAND
legal description land. It be from County
Attach a copy of the of
Assessor's office or it may be typed or
your can obtained your
printed on an Additional Attachment Form (TD -420-732).
X REMOVED
PROPERTY TAX PARCEL NUMBER
45164.0244
Manufactured home will be
AFFIXED
3 TITLE COMPANY CERTIFICATION
1 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
1 cert-fy that the manufactured home has been affixed to the real property as described, or a building
per it has bee issued for this purpose and the attachment will be inspected upon completion.
BLDG PERMIT,.
' O(27_3,') S
NAM
IVr y iJ�
SIGNATURE/TITLE
OUNTY
X
BU NnINO AND PLANNING
BLDG PER T OFFICE/PHONE 1
(�/ / '7:��Cr..` 175
DATE
���/�
OW ER INFORMATION
UtV1StON OF
FEES
COUNTY A INC UNINC
❑ ❑
1
A REGISTERED
OWNERS
A LEGAL OWNERS
Provide the Washington Driver's License or 10.
card number (PIC) for each owner:
FILING FEE
NAME OF FIRST OWNER
R
RUTH A. BRANSON
BRANSRA5844-1
APPLICATION
G NAME OF SECOND OWNER
I
S
MOBILE HOME FEES
T
E ADDRESS OF OWNER
R
E 12101 East Valle - Avenue
--OR-- if the owner is a business.
ELIMINATION
I
0 CITY
Spokane
STATE
WA
ZIP CODE
99206
provide the Unified Business
Identifier (UBI), found on the
business Registration & Licenses
USE TAX
NAME OF FIRST LEGAL OWNER'
SPOKANE TEACHERS CREDIT UNION
Document.
SUB -AGENT FEES
I
NMAILING ADDRESS OF FIRST LEGAL OWNER
H. PO BOX 5264
More than two owners or one
lienholder? Please use attachment
TOTAL FEES & TAX
L CIN
STATE
ZIP CODE
form(s) #TD -420-732.
D SPOKANE
E
WA
99205
DEALER'S REPORT OF SALE
R 'SIGNATURE OF LEGAL OWNER INDICATES•CONSENT FOR ELIMINATION OP TITLE/REMOVAL
FROM REAL PROPERTY: 7 • � ti�
I certify that this information is correct. The vehicle is clear
of encumbrances except as shown.
Anyone who knowingly makes a false stateme of a material tact is guilty of a felon , nd
upon conviction may be punished by a fine of up to $5,000 and/or 10 years imprisonment
(RCW 46.12.210). Imo• a OLEMNLY ATTEST UNDER PENALTY OF PERJURY LAW
THATI/WEAR 4L�: •ISTE WNER FTHISVEHICLE ND THIS INFORMA-
TION IS • : - -' • Ow g eta itle(s):
X ,.., 44
WA DLR NO.
DATE OF SALE
PURCHASE PRICE
.
DEALER NAME
TAX JURISDICTION/TAX RATE
DEALERS AUTHORIZED SIGNATURE
X �`I��
USE TAX EXEMPT Sale to a Certified Tribal member on
the reservation (attach notarized statement of delivery)
44. Off
X `♦ �: •
NOT Y OR LIC 9E AGENT b NUMBER 42:1 !! 1,07 AR r
X I. f l Y ��(.�/� Cps -
r�y
.6U�SCRIBED TO AND SWORN BEFORE ME THIP Residing in (County)
••8 DAY OF April 19 9. 6 „�^kane, WA
6 COUN / AUDITOR/A(3 .LicEPNI
�F/C' PROVAL: (Not for u `,: nts) �.
I certify that the above appliy pgaf
proceed with the recording ocscflaf 1
t.q�`i�e been completed ' `= ., •• - -Iicant has sufficient documentation to
• �H�`` `e>
NAME fan i 11
0I TRE
X
OFFICENFS OPERATOR NUMBER
DATE
TD -420.729 MANUF HOME APPL (R/2/94)M Page 1 at 2