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1998, 11-30 WA State MH Application i 1 • RETU N ADDRES N --... \&((C,Ka(\ \ N-Qc , p, 0 qq4 1 (71 A°' ' 4alz 4 q_5(M - ''\-e-, 5.te,),a il.e. , .v_ L41DTA TE sT:r�n°rn t o f"`"s"': °" MANUFACTURED H IiCEflSinç APPLICATION PLEASE CHECK ONE ©TITLE ELIMINATION 0 TRANSFER IN LOCATION ❑REMOVAL FROM REAL PROPERTY D MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) $02065 1977 CASTH hn X 26 4765UX ©LAND ADDITIONAL LEGAL DESCRIPTION ON PAGE TITLE FEES MANUFACTURED HOME WILL BE ®AFFIXED ❑REMOVED 3s/A Pq�F}AtpgER n FILING FEE da`}`i vV11 J��.'1l�lfJ n APPLICATION LOT BLOCK PLAT NAME SECTION/TOWNSHIP/RANGE 7 7 WOODLAWN PARK ADDITION MOBILE HOME FEE A legal description can be obtained from the local County Assessor's Office.If there is not enough room here, use the Application Attachment form,TD-420-732,available at your local County Auditor's Office. ELIMINATION FEE Lot 7, Block 7, WOODLAWN PARK ADDITION, according to plat USE TAX recorded in Volume "0" of Plats, Page 23, in the City of Spokane, Spokane County, Washington. SUB-AGENT FEES TOTAL FEES&TAX ©GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY M INCORPORATED UNINCORPORATED N REGIST,D OWNERS k LEGAL OVV�JERS NAME OF FIRST REGISTERED OWNER C9„a�rr��S�p ME�COUNT N MBER Gerald R. Pellet' LLc V K�3' ADDRESS OF FIRST REGISTERED OWNER CITY STATE ZIP CODE 7120 E. 9th Ave Spokane WA 99212 NAME OF FIRST LEGAL OWNER DOL S M ACCOSINT NUMBER Gerald R. PPl leery L.�- l�%!� j A SS OF FIRST LEGAL OW R CITY STATE ZIP CODE � 20 E. 9th Ave. Spokane WA qq212 GRANTEE(S) ADDITIONAL NAMES ON PAGE NAME OF FIRST GRANTEE DOL CUSTOMER ACCOUNT NUMBER Anyone who knowingly makes a false statement of a material I DO SOLEMNLY ATTEST UNDER PENALTY OF PURJURY fact is guilty of a felony, and upon conviction may be LAW THAT I/WE ARE THE REGISTERED OWNERS OF punished by a fine,Imprisonment,or both.(RCW 46.12.210) THIS VEHICLE AND THIS INFORMATION IS ACCURATE: SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMIN TION OF TITLE/ EMOVAL FROM REAL PROPERTY: X.r Qa�-� L� Gee-e.. R eF FIRST REGIS. • ER AND TITLE,IF APPLICABLE 'II SIGNATURE OF FIRST LEGAL OWNER D TITLE,IF APPLICABLE SIGNATURE OF SECOND REGISTERED OWNE j/.ND TITLE,IF APPLICABLE .y NOTARY SEAL OR STAMP /- NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE ' OFFICIAL SEAL State of Washington Signed or attested (: County of �►�►.. before -eon I �v NINA M.RAPP (0,1(1 . 1' . , ,.4 t ' � t � " #. Alm habit—SbtfiOtrMp1184)Allo* ' by- le M - . �l� !i l_� Printed 'amen-v• licant —JJ Epirus 1184) Dealer No.OR Title AND:County/Office No.OR DEALERSHIP Position/Agent/NOTARY Notary Expiration Date s DEALER'S REPORT OF SALE I certify thatthis information Is correct.The vehicle Is clear of encumbrances except as shown. t DEALER NAME WA DEALER NUMBER DATE OF SALE A2-.f.,. ` WK PURCHASE PRICE TAX JURISDICTION/TAX RATE DEALER'S AUTHORIZED SIGNATURE 0 USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery). cii COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL:(Not for use by Sub-Agents) 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(TYPED OR PRINTED) COUNTY OFFICENFS OPERATOR NUMBER �''' SIGNATURE DATE r TD•420.729 MANUF HOME APPL(R/12/96)OR Page 1 of 2 INSTRUCTIONS AND ADDITIONAL INFORMATION ON REVERSE SIDE ti Y 4 Li TITLE COMPANY CERTIFICATION I 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/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. D BUILDING PERMIT OFFICE CERTIFICATION I certify that the manufactured home has been affixed to the real property as described,OR a building permit has been issued for this purpose and the attachment will be inspected upon completion NAME u/� �ry � PERMIT OFFICE/PHONE I SIGNATURE PO TIOPIPOKANE COUN 1r�I7 7)- 4 o:��,� ,�i t y #0,ION OF BUILDINGS DAT INSTRUCTIONS 'r��� - I CJD COMPLETE THE APPROPRIATE BOXES ON THE FORM AS INDICATED BELOW, DEPENDING UPON THE TRANSACTION YOU WISH TO PROCESS. A. Manufactured Home Title Elimination Application(complete boxes 1,2,3,4 and 6). Use to eliminate a title for a manufactured home which is to become real property. B. Manufactured Home Transfer In Location Application(complete all boxes). Use only when a manufactured home(whose title has been eliminated)is being moved to land with a different legal description AND will become part of the real property to which it will be moved and affixed. If the transfer in location is between two different counties,prepare this form in duplicate and have each recorded in its respective county. C. Manufactured Home Removal From Real Property Application(complete boxes 1,2,3,4 and 5). Use when titling a manufactured home whose title has been previously eliminated. Once properly completed and recorded,this application becomes a supporting document along with others required to apply for a Certificate of Title for the manufactured home. IMPORTANT: SIGNATURES OF THE OWNERS ON THE MANUFACTURED HOME APPLICATION INDICATE TERMINATION OF INTEREST IN THE MANUFACTURED HOME THROUGH TITLE PROVIDED BY CHAPTER 46.12 RCW AND INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE LAND HE/SHE/THEY OWN AND TO WHICH IT IS/WILL BE AFFIXED. IF THE MANUFACTURED HOME IS BEING REMOVED FROM REAL PROPERTY,SIGNATURES OF THE OWNERS PER THE REAL PROPERTY RECORDS INDICATE CONSENT TO THE REMOVAL. THE FORM MAY THEN BE USED FOR MAKING APPLICATION FOR TITLE WITH THE DEPARTMENT OF LICENSING AS PROVIDED BY CHAPTER 46.12 RCW. Note: Owners of the manufactured home must own the land when the application is for a Manufactured Home Title Elimination or a Manufactured Home Transfer In Location,as provided by Chapter 65.20 RCW. SECTION 1 Enter the description of the manufactured home. SECTION 2 Place an"X"in the appropriate box and enter the property tax parcel number,lot,block,plat number and section/township/range,when applicable.Write a legal description in the space provided. If there is not enough room, use the Title Application Attachment(TD0420-732).When processing a'Transfer in Location Application,'both boxes should be checked.The application must then be accompanied by two separate land descriptions. SECTION 3 This area must be signed by all registered owners of the manufactured home when processing a title elimination. if the manufactured home has been sold and is being removed from the real property,the owners per the real property records must complete this portion to obtain a Certificate of Title. Signatures of the owners must be notarized or certified by the selling dealer or a vehicle licensing agent. Fees will include a filing and application fee plus sales or use tax due. Additional fees may include:a title elimination fee and a Mobile Home Affairs Fee. Subagents will charge an additional service fee. (Fees are subject to change without notice.) SECTION 4 Take the properly completed Manufactured Home Application and all necessary supporting documents to the County Auditor/Licensing Agent Office for approval. Supporting documents may include but are not limited to: proof of ownership or a Manufacturer's Statement of Origin(MSO),proof of taxes paid,and applicable release(s)of interest. Subagents may not complete the approval portion of this form. SECTION 5 The"Title Company Certification"box must be completed when processing a"Transfer In Location"or a"Removal From Real Property"application. Important: The final recorded application form must be submitted to a vehicle licensing agent within 10 days of the title company's certification. SECTION 6 When processing an"Elimination"or'Transfer In Location"application,a city or country of8ce^�(dependiiig upoh1 location of the manufactured home)must certify that the home is affixed to the land;o,isttf3a.building perm(ttcffi the manufactured home to the land,inspecting the completed attachment. The issuirt. p,, kt sign the.-, application,adding the permit number if the inspection has not yet occurred. IMPORTANT: Once the application has been approved by the County Auditor/Licensing Agent Office,take your application -t form to the County Recording Office. Retain proof of the recording fees paid. If the Recording Office retains your original application form,obtain a certified copy of the recorded form. APPLICANTS: Once recorded,you must return to a Vehicle Licensing office to file the Manufactured Home Application, paying all required fees. • • The Department of Licensing has a policy of providing equal access to its services. If you need special accommodation,please call(360)902-3600 or TDD(360)664-8885. TD-420-729 MANUF HOME APPL(R/12/96)OR Page 1 of 2 • --. _.__ _ -__- J