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2006, 09-10 Title Elimination
RETURN ADDRESS AarOara 5 7 S A /) 33!'�t /Vc1/'f1 c/ //je-X?ogd SickzCan e v/ G%2c-i ?cam • LEASE CH CK ONE ��,STATEOF wnheINGTON MANUFACTURED HOME /n J APPLICATION TITLE ELIMINATION icEnsinc DTRANSFER 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) 1 MANUFACTURED HOME TPO / PLATE NUMBER +12813 YEAR 79 MAKE FLEETWOO LENGTH/WIDTH(FEET) 24 X 60 VEHICLE IDENTIFICATION NUMBER (VIN) 1DFL 2 © LAND LEGAL DESCRIPTION ON PAGE MANUFACTURED HOME WILL BE o AFFIXED A REMOVED REAL PROPERTY TAX PARCEL NUMBER 45094.0525 LOT TRACT 2 BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE SHORT PLAT NO.. 95-1016 OUARTER/OUARTER 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 BARBARA J. TISH NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS �pp cA • CITY /- Q / STTAAATE,w,y4ZIP CODE J �36 J A/orf-L W 1 lb ur Rd 3/)494nc-< aili-e'DOLCUSTOM9A720 - �_ NAME OF LEGAL OWNER / WELLS FARGO NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 600 I08TH AVENUE N.E. BELLEVUE WA 98004 GRANTEE NAME 1 DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I / WE AM/ARE THE REGISTERED OWNER(S) OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: Signature Registered Owner Title, IF APPLICABLE-�� of and Signature of Additional Registered Owner and Title, IF APPLICABLE NOTARY SEAL OR STAMP I NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S) SIGNATURE 11Rd'-.r�3at f Washington ,y/LA Signed or attested I,Ca County of before me on '-f`/ �C' L. % .64 %i Ll Signatur theirOF 1 ylY �i- t'ic' T I G�J • V f ( I �I NT NAME OF REGISTERED OWNER /� ��1 rnnY .Ni/// �q� l AiC-/vti/ /' 2dt a 3 I.I ^'� PRINT NAME OF REGISTERED OWNER PRIMED NAME OF OTARY '"'�"�.5.-,, 4 .. I County/Office No. OR Title AND: Dealer No. OR DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date Lj - -0 -75 Ej 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. 0 BUILDING PERMIT OFFICE CERTIFICATION 1 Certify that: O the manufactured home has been affixed to the real property as described. 01 a building permit has been issued for this purpose and the attachment wi I be inspected upon completion. NAME (TYPED OR PRINTED) BLDG PERMIT OFFICFJPHONE # Se . \Slct k f, -SCG-( 1-2-03 BLDG PERMIT# 31 uv -1(a3 SIGITA RE/P�ITION \ c,, ,p DAjE 1 r l/ C e) ,' .da- '�QQ C' LGi'.(?ta c\ —`O-C 4�