HomeMy WebLinkAbout1996. 07-26 WA State MH App 0 sr, I;(I(Irar o/1••.151NNGTON RECORDER'S CLOCK
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!1iEfisinc MANUFACTURED HOME APPLICATION
TITLE OPTIONS
Original n TITLE ELIMINATION (Complete all but section 3, below)
_ Transfer TRANSFER IN LOCATION (Complete ALL sections below)
Duplicate — REMOVAL FROM REAL PROPERTY(Complete all but section 4, below)
Reissue
-- RECORDED AT
REQUEST OF:
1 MANUFACTURED HO ME
YEAR MAKE WIDTH/LEND TM VEHICLE IDENTIFICATION Dumont IVINI COIOR♦I COLOR 52
1989 MARLS70/14 1G1101141J3002958 TOP on
BOTTOM on
'FRONT: IREARCOLOR:
2 LAND
• Attach a copy of the legal description of your land. It can be obtained from your Cou Ity_Assessor'.s_office.
• Land to which the manufactured home is being AFFIXED I J REMOVED MOPE/ITT TAX PARCEL NUMBER
_ _ __ 35232.1419
_ TITLE COMPANY CERT/FICAT/ON —
I certify that the legal description of the land and ownership are true and correct.
NAME TITLE COMPANY/PIIONE NUMBER SIGNATURE • DATE
_1_ �X _
NOTE: Application must be finalized with a Licensing Agent within 10 calendar days of the dote signed by the Title Company Representative.
4 BUILDING PERMIT OFFICE CERTIFICATION
I certify that the manufactured home has.been affixed to the real property as described, or the re`�PTJIMIrs
following building ,permit has been issued for this purpose and will be inspected upon completion.L r 4g,1/
rM E SIGNATURE/TITLE BLDG P IT OFFICE/PHONE NUMBER DATE 1/-49'
k UC,C __ X SPOKANE COUNTY PERMIT CENTER I �- (G,7 I l/Iv9'(l,C�
OWNER INFORMATION 'FEES
v COUNTY, 'INC UNINC NUMBER OF - NUMBER OF Please provide the Department of Licensing (DOL) FILING FEE ;
n_ I I REGISTERED OWNERS�I LEGAL OWNERS 1 Client "NUMBER" for each owner:
NAME OF FIRST REGISTERED OWNER I
Ryan S. Dunlavy I(�)�) '^1 /� t' APPLICATION
NAME OF SECOND REGISTERED OWNER " N if-IA I� )�)�l�Iq )V 1 t
1 Mb61lE"Mr
"—
This
EE?:�.-�-—
ADDRESS OF FIRST REGISTERED OWNER –
_I,...1__ I. 1 __1_1_1_1_._I_�__-1_
This "NUMBER" may be found on )
5007 East 2rd Avenue your Washington Drivers License/ ELIMINATION
CITY STATE ilrc00 I.D. Card--OR--if the owner Is a
Spokane, Wa 99212 business, provide the Unified l_.—_
• NAni(of rinsi LEGAL ownEn• • `------- —" business IdontifierlUBl) number, USE TAX
`ate - 5 �ti ' ._I- 1 1 I I I I 1 1 1 1 ...-_ I_.
v. MAILING ADDRESS OF FIRST LEG OWNER soli-AGENT FEES
f! __ More than Iwo registered or
L
1
A CITY STALE ZIPCODE one legal owner? , , ,
L
Please use attachment forms TOTAL FEES &TAX
•I' •SIGNATURE OF IEOAI OWNER INDICATES CONSENT Tort DATE (TD-420.732)
+ ELIMINATION OF TITLE: X I
TT-999991,
Anyone who knowingly makes a false statement of a meter) dtic I r 4q� PURCHASE PRICE
of a felony, os DEALER'S REPORT OF SALE
and upon conviction may be punished by a line/t 11;r01102,,,,,,OO
$
and/or 10 year.imprismtment(RCW 46.12.2101.I DD Sg4�Mr l.Y�'•Ijf �'.L �q
UNDER PENALTY OF PERJURY LAW THAT I/WE An 4111E (tF�(D�STEHED1Od 7►c,rac(,ertify that this vehicleI.Information ear Is
i trrrect- The Is clear of TAX JURISDICTION/TAXRATE
OWNERS OF THIS VEHICLE AND THIS INFORMATIO ISA p�`^ i"; •
R•d•tei J.wrrsrgpn.tur4I: IGD Q ,YvfAf(Y W� enAumbrancea except as shown.
�( i' ' / �i I� /4. /� ,a _ _ 1UEA R NAME DATE OF SALE
w CL IC 2
X • ',•'' G4RY 19 .' NO, DEALER'S AUTHORIZED SIGNATURE
Ssi0P WASH �0* X _
+OTAR;On •scribed and S ern I••Elliott'M• Ns Residing in
1 : .{-� USE TAX EXEMPT sal•to Indian on the
�!ik '` 'dW of _ ,_ ' 19 t-( County Reservation'attach notarized'movement of delivery)
1 COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL:(Not/or use 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 OFFICE/WS OPERATOR NUMBER DATE
X
RECORDING OFFICE
This form has been rec. d.g.d in . _ :aunty records.
RECORDING NUMBER .5, '""` t COUNTY I VOLUME/PAGE DATE
Cr :ray- :-./ A.
TD•420.729 MANUF HOME APPLIR/7/93108 I Page 1 of 2 F,,/