2010, 05-17 Title EliminationRETURN ADDRESS
Inland Professional Title
25 West Cataldo Avenue, Suite B
Spokane, WA 99201
Al
4STiiTC OF WA.SHINGTOi\� a fps ° s '0Ar
"�°``""""°t MANUFACTURED
TITLE ELIMINATION
IICEDSInG ,APPLICATION ❑TRANSFER IN LOCATION
,. Li l'- ❑REMOVAL FROM REAL PROPERTY
Anyone who knowingly makes a false statement of a material fact is guilty
of a felony, and upon conviction may be punished by a fine, imprisonment, or both. (RCW 46.12.210)
MANUFACTURED HOME
TPO / PLATE NUMBER
128114
YEAR
1997
MAKE
MARLE
LENGTH/WIDTH(FEET)
70 14
VEHICLE IDENTIFICATION NUMBER (VIN)
H013706
LAND LEGAL DESCRIPTION ON PAGE 2
AFFIXED 0 REMOVED
MANUFACTURED HOME WILL BE;
�55183.0547
REAL PROPERTY TAX PARCEL NUMBER;
LOT
Ptn Lot 4
BLOCK
17.
PLAT NAME OR SECTION/TOWNSHIP/RANGE
Corbin Add. to Greenacres
QUARTER/QUARTER'SECTION
GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE:'
COUNTY NUMBER
NUMBER OF REGISTERED OWNERS
1
NUMBER OF LEGAL OWNERS
1
NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT, NUMBER
Nathan A. Foubert
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
506 North Corbin Road Spokane Valley WA 99016
NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
Bank of America
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
11707 East Sprague Avenue Spokane Valley WA 99206
GRANTEE
NAME
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY
VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title, IF
Signature of Additional Registered Owner and Title, IF
THAT I
if
APPLICABLE
/ WE AM/ARE_THE REGISTERED OWNER(S) OF THIS
APPLICABLE
No;Any,0\11)8AIST tt3 ,1�,/f 1
. `S' •...... .. 0 ',State
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='PRINT
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/�///ealer
///�/((t1ASVw `\\\\\\ TitleDEALERSHIP
NOTARIZATION/CERTIFICATION
of Washington
County of
/ f % 12
FOR REGISTERED
C.5 �,2,-../.-/7 ---
OWNER(S)
Signed or attested
before
SIGNATURE
' / �y
me on / '' /,/c
as . /1-0 Lt`l'-/r Si. nature
„dem i
NAME OF REGISTERED OWNER
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OT' ` O Gam^
/
A ter•
PRINT NAME OF RE (STERED OWNER
PRINTED
NAME F
ounty/Office
AND. Notary
NOTARY
No. OR
No. OR
POSITION/AGENT/NOTARY
EDxpiration Date
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
SIGNATURE / POSITION DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
BUILDING PERMIT OFFICE CERTIFICATION
I Certify that 0 the manufactured home has been affixed to the real property as described.
0 a building permit has been issued for this purpose and the attachment will be inspected upon completion.
NAME (TYPED O PRINTED) BLDG PERMIT OFFICE/PHONE #
BLDG PERMIT #
SIG ATURE / PO (TION DATE
QX '- e sSr-- 51)7)10
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