2007, 03-14 WA State MH App eettillnallialliftWitli
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Manufactured Home 'L AS CH CK ONE
AWASHINGTON STATE DEPARTMENT OF [TITLE ELIMINATION
LICENSING Application ❑TRANSFER IN LOCATION
Anyone who knowingly makes a false statement of a material fact is guilty DREMOVAL FROM REAL PROPERTY
of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210)
1 MANUFACTURED HOME
TPO/PLATE NI Irma.= I YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN)
2006 Goldenivest 70 X 28 ALSO i(0 0 IQ
2 LAND LEGAL DESCRIPTION ON PAGE
REAL PROPERTY TAX PARCEL NUMBER
MANUFACTURED HOME WILL BE XAFFIXED 0 REMOVED 45202.1403
LOT .3 BLOCK PL .1?A CTION/TOWNS
1rH`IP/RANGE QUARTER/QUARTER SECTION
i JK
3 GRANTOR(S)REGISTERED/LEGAL OW.NER(S) MALA ADDITIONAL NAMES ON PAGE
COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS
1
NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
Evelyn R.Angeleri
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
614 S.Woodruff Rd. Spokane Valley wa 99206
NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
Countrywide Home Loans,Inc.
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
11707 E. Sprague Spokane Valley wa 99206
GRANTEE
NAME
Evelyn R.Angeleri
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE AM/, 'wsa" " G- ERED OWNER(S)OF THIS
VEHICLE AND THIS INFORMATION IS ACCURATE: �,-. it
Signature of Registered Owner and Title,IF APPLICABLE t .�`'
ik rpy�t,u�resp ,trait al Registered Owner and Title,IF APPLICABLE
• 6�IGAYER 11x1'•`, f/ P NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE
yi-s...�,ft7N c�'A!` fi/,` State of Washington '/ Signed or attested Jict/o 04 '%p , County of m0i(1� beforeme on ��
, 0 4 = byEveA,,n 1� , nnci&ev; Signature V.Abt- - !//,145m �(,�-
A �/ Ura L., y PRINT N OF REGISTERED NER NOT Y OR AGENT
of ill -2b-C1�.�` ti Ah i>�'1 /7/, 14-0511&
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• '1'"��\, -Z.r by PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY
rti'lll WASP', " Title r�1 /' County/Office No.OR
Nv - AND: Dealer No.OR .,,
DEALERSHIP POSITION/A ENT/NOTARY Notary Expiration Date 3j/,�L /L)g
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
Spokane County Title
SIGNATURE/POSITION DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
5 BUILDING PERMIT OFFICE CERTIFICATION
I certify that:0 the manufactured home has been affixed to the real property as described.
• ® a building permit has been issued for this purpose and the attachment will be inspected upon completion.
NAME(TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE N BLDG PERMIT N
SIGNA RE/POSITION DATE
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