1994, 11-22 Title Elimination Page 2 c,co cam. 3 oo z Z / /ID s U,Sll�l4�1
Manufactured Home:
Year 1985 Make NASHU Width 14 Length 70
Vehicle Identification Number 570142BRFKRI26673
Registered Owners:
Names Betty M. Good Signatures'
Legal Owners:
> Names Directors Mortgage Signature
'SIGNATURES OF OWNERS INDICATE TERMINATION OF INTEREST IN THE MANUFACTURED FTOMe THRLJCJ L"RIIVIOED BY'Cq PE,R 4Y.iZrR@N/Me'
INDICATE INTENT TO PERFECT INTEREST IN THE MANUFACTURED HOME AS REAL PROPERTY WITH THE ND HE/SHE/THEY OWN AND TO WHICH IT IS/IS
BEING AFFIXED.
Land to Which Manufactured Home is Being Affixed:
Property Tax Parcel Number 45203.0513
Legal Description Lot 1 & the N# of Lot 2, Blk. 5, Siesta Mobile Park Addn. , County of
Spokane, State of WA
Owners' Names Betty M. Good Signatures'
'SIGNATURES OF OWNERS INDICATE CONSENT TO HAVE THE MANUFACTURED HOME ADDED TO THE F AL PROPERTY LISTED ABOVE.
Building Permit Office Certification:
•
I certify t t the m_ of ctured home has been affixed to the real property as described above and/or building permit
numb �/ / has been issued for the purpose of affixing the manufactured home to the land and will be
insp cted upon co tion.
SPOKANE COUNTY
T
SYON ii/ f/(% ( 000.' �;�, 8Pi
NA E SIGNAT RE L G.P MI OF ICE S ATE PHONE NUMBER
County Auditor/Agent Licensing Office Approval: (Not for use by subagents) •
I certify that the above application appears to have been completed correctly, and that the applicant has sufficient
documentation to proceed with the recording of this form.
NAME SIGNATURE OFFICE/CARP OPERATOR NUMBER DATE
Recording Office:
I certify that this form has been recorded in the county records.
NAME SIGNATURE COUNTY GATE RECORDING NUMBER
Note: Every person who falsifies or intentionally omits material information required in an affidavit is guilty of a gross
misdemeanor punishable in accordance with RCW 9A.20.021.
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