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1999, 04-19 WA State MH Title App I / . iRETURN ADDRESS /y i, ` /A Ft 2i C�f�UYl a /O /0 ti • /J - k_d 3 1.6 _e e4J71- 92 )r L DSrpfT=orTF OFrnf ofLVA5hh1 TON MANUFACTURED HOME Irn6 _ 7/ 2/ ICEflSIflG APPLICATION S - .F1..2_,( PLEASE CHECK ONE ®TITLE ELIMINATION 0 TRANSFER IN LOCATION 0 REMOVAL FROM REAL PROPERTY 0 MANUFACTURED HOME ' TPO/PLATE NUMBER YEAR .....,, MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) JQSr1mT,'I-CcLfF X 22-66Y-SDo2 -SZof(, ©LAND ADDITIONAL LEGAL DESCRIPTION ON PAGE _ TITLE FEES MANUFACTURED HOME WILL BE ❑AFFIXEDFILING FEE 0 REMOVED 4 a�.g • /2.12 BER LOT BLOCK PLAT NAME Lf / APPLICATION SECTION/TOWNSHIP/RANGE 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 The North 105 feet of the South 447 feet of the West Half of the East Half of Tract 168, VERA, , as per plat recorded in Volume 'O• of Plats, page 30, records of Spokane County; USE TAX EXCEPT the South 25 feel deeded to Spokane County for Thirteenth Avenue by deeds SUB-AGE-NrFEES recorded under Recording Nos. 93052(10132 and 93nc760135; The above Is also shown as Tract'A'of Survey recorded March 31, 1993 under Recording No. TOTAL FEES TAX 9303310400 In Book 55 of Surveys, page 61, records of Spokane County; Situate In the County of Spokane, Stale of Washington. © GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY a INCORPORATED UNINCORPORATED N REGIS FRED OWNERS k LEGAL OWNERS , NAVE OF FIRST REGISTERD OWNER DOL CUSTOMER ACCOUNT NUMBER 1)0)1(10_4 ai/ I 1 I.a1m S WILL I,D.31'-4 z / aid ADDRESS OF FIRST REGISTERED OWNER CITY STATE ZIP COnF i s Dos f ,s-f- i3 rr' VP �(r� lA)4 - g1 0 NAM OF FIRST LE L OWNER DOL CUSTOMER ACCOUNT.' J BER J r�( USI 11 f1�W o- ' ,t/"U I C�I —b r ego A - ADDRESS OF FIRST GAL OW CITY STA_ ,,TE ZIP CODE to ( .2,i &' u,nn-Cry to .2(,0 C'(cc a.i? ,S' Ori 8701 tS- 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 OWNER OF punished by a fine,Imprisonment,or both.(RCW 46.12.210) THI" EH E AND TIS I Fa ATIO ..IS AC*d R SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR — ELIMINATION OF TITLE/REMOVAL FROM REAL PROPERTY: X '�-,igh„Ed -// AK" — '' - -- n0 1ATURE OF FIRS•EGIST RED OWNER AND TITLE,IF APPLICABLE SIG URE OF FIRST LEGAL OWNER AN TITLE IF APPLICA' E SIGNATURE OF SECOND REGISTERED OWNER AND TITLE,IF APPLICABLE ;T 1'�Q ►il, I NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE • {Of) •�s��'�'•I Stale of Washington ���ice. �. Signed or attested / - e„ /n�oro • �'t�Y i,...0.:,11 ,. County of 4 before m..n r ` b y_ � J (.vrlLl/ i r ... PUBjC 11. Printed Name of ApplicantSi n re:It. �� �j "/ �// Dealer No.OR ?. fLO � I Title !l(/F /yam�c i AND:County/Office No.OR , �..� : :{` I DEALERSHIP Position/Agent/NOTARY Notary Expiration Date ii11i111111 DEALER'S REPORT OF SALE I certify that this information is correct.The vehicle Is clear of encumbrances except as shown. DEALER NAME WA DEALER NUMBER DATE OF SALE 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). n COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL:(Not for 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(TYPED OR PRINTED) COUNTY OFFICENFS OPERATOR NUMBER SIGNATURE I DATE TD-420-729 MANUF HOME APPL(R/t2/96)OR Page I of 2 INSTRUCTIONS AND ADDITIONAL INFORMATION ON REVERSE SIDE '`- -- s .1 ( ' U TITLE COMPANY CERTIFICATION 1 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 ElFinalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. BUILDING PERMIT OFFICE CERTIFICATION I certify that the manufactured home has been affixed to the real property aseescb QR a building permit has been issued for this purpose and the attachment will be inspected upon completion #1 Cr 71-CrI r(i ME BLDG PERMIT OFFICE/PHONE a E,l -J-n e;Jr- 1')-31,,T1 " SIGNAT RE/POSITION SPOKANE COUNT OJ T DATE)A �_ / "T' [SION OF BUILDIN I SIlq INSTRUCTIONS 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 lees 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 Reai 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 county office (depending upon the location of the manufactured home)must certify that the home is affixed to the land;or,issue a building permit to affix the manufactured home to the land,inspecting the completed attachment. The issuing office must 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 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 —,