2008, 02-05 Permit App 1723 MHAFTER RECORDING MAIL TO:
First American Title
12209 E. Mission #3
Spokane, WA 99206
Filed for Record at Request of: amK m/r a e ler Recun3ers use ar
First American Title Insurance Company
g,Y.4F,,;OGfVN MANUFACTURED HOME
V1p,A,(:
`
�ir� �.�" fir. APPLICATION X TITLE ELIMINATION
i��JI�Y TRANSFER IN LOCATION
Anyone who knowingly makes a false statement of a material fact is guilty ❑ REMOVAL FROM REAL PROPERTY
of a felony, and upon conviction may be punished by a fine imprisonment, or both. RCW 46.12.210
MANUFACTURED HOME
TPOIPLATE NUMBER
YEAR
MAKE
lEN(TH/WIDTH (FEE -n VEHICLE IDENTIFICATION NUMBER(VINI
8517717405
1985
AMER
64 28 KBIDSNABS13167
LAND LEGAL DESCRIPTION ON PAGE 2
REAL PROPERTY TAX PARCEL NUMBER
MANUFACTURED HOME WILL BE Q AFFIXED 0 REMOVED 55064.0204
LOTCK
PLAT NAME OR SEMONfTOWNSHIP/RANGE
OUARTER/OUARTER SECTION
4 1
1BLO
I Donwood East Subdivision//
GRANTORS REGISTERED/ LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY NUMBER
NUMBER OF REGISTERED OWNERS
NUMBER OF LEGAL OWNERS
0146
1 1
0
NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
Ramona L. Lance
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
18621 E COURTLAND AVE, SPOKANE VALLEY, WA 99216
NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
4161 Piedmont Pkwy, Greensboro, NC 27410
GRANTEE
NAME
N/A
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE /ARE THE REGISTERED OWNER(S) OF
THIS VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title, IF APPLICABLE
is
Signature of Additional Registered Owner and Title, IF APPLICABLE
NOTARY SEAL OR STAMP I •NOTARIZATION/CERTIFICATION FOR REGISTERED OWNERS) SIGNATURE
IIIII I III 111111111111111111111111111111(}] State of Washington signed or attested C1-
'
Notary Public = County or Spokane before me r
ate of Washington by Ramona L. Lance Sg aJL�rL Gln ,.ti s-
RETCHEN SATRAN PRINT NAME OF REGISTERED OWNER NOTARY OR AGENT
by GrQ�cVwt, gvak.
COMMISSION EXPIRES
_*
May 19, 2009 = PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY 1
= Cwnbv/ONkc No. OR
Notary `tom
IlllllllllllllllllllllllllllllllltlUl(� nrk AND ogler No. OR
I DEALERSHIP POSTTTON/AGENT/NOTARY Notary Expratlon Date
TITLE COMPANY CERTIFICATION
I certify that the legal description of the land and ownership is true and correct per the real props records.
NAME T'PED OR PRINTED) TITLE COMPANY/PHONE NUMBER
Sherry Stolz, First American Title Insurance Com an (509)838-5281
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
LJ/ the manufactured home has been affixed to the real property as described.
I certify that:
® a building penult has been Issued for this purpose and the attachment will be Inspected upon completion.
NAME PED OR PRINTF ' BLDG PERMIT OFFICE/PHONE #
BLDG PERMIT X
S[ E/POSTnON DATE
?s
TC7
MANUF HOME Af=Page of
First Amerkan Title FIM No. 4763-1104676 (GS)