HomeMy WebLinkAboutBLD1994-00711 .
.L,CTATE OF W SHINGTON RECORDER'S CLOCK
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lICEnSInGH MANUFACTURED HOME APPLICATION
TITLE OPTIONS
Original TITLE ELIMNATION(Complete al but ssodon S.below)
Transfer TRANSFER N LOCATION(Complete ALL sections below)
Duplicate REMOVAL FROM REAL PROPERTY(Complete ail but section 4.below)
Reissue neoloU AT •
asouoT OP:
1 MANUFACTURED HOW
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1988 Lamplightet 28X52 I 19735 TOP OA
2 ' LAND
• Attach a copy of the legal description of your land. It can be obtained from your Cou ty Assessor's office.
• Land to which the manufactured home is being:ID AFFIXED p REMOVED WWII"
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961802315 & 317
3 /77ZE COMPANY CERTI I;ATION
I certify that the legal description of the land and ownership are true and correct.
NAME ' .....::<?«<.>''<g:%'3.:k::::...5.TmIGDMP PFNE tEMIL UMISSlA s ' �ifru►Tutr..>.:s. v:;v::M;::,:; :;.,:•>:.X.: <:::::;rvv.:: •: DMZ
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NOTE: Application must be finalized with a Ucerwing Agent whin 10 calendar days of the date signed by the Title Company Representative.
SIIR•DIIG PERAUT OF CERTIFICA77011
I certify that the manufactured home has been affixed to the real property as described, or the Min I
following building permit has bee iii ed for this • • •se and will be inspected upon completion.
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Ilr MOVER INFORMATION
5 coon• Ienc usec NuwE1R OF �LEGAL
Of e Please provide the Department of Licensing IDOL) FILM.FEE
El kTe REast®OWNERS' 1 1 AL • Client'NUMBER'for each owner: I
NAME OF FIRST REGISTERED OWNER ``'' �AFPLICATION
HONEY H. VON GOERKEN VI /V m
Oioll rl l l C
NAME OF SECOND REGISTERED OWNER I
I I I I I IA I I ) I MOW HOME FEES
ADDRESS Of FIRST REGISTERED OWNER This"NUMBER*may be fond on I
2137 Washington St. #3 year waehineon DAMNS Uwsd ELIMINATOR
CITY STATE 2IRCODE I.D.Card—OR—B the owner is a
Port Townsend WA 98368 business,provide the Unified 1
• USE TAX
NAME OF FIRST LEGAL OWNER• business Ide `ntifierlUB1)n/umber.
WASHINGTON MUTUAL SAVINGS BANK 5il igint 1 %.317 1—VI 1
MAILING ADORERS OF FIRST LEGAL OWNER i1GI AGENT FEES
500 Pacific Ave. 3rd Floor More than two registered or I
CITY STATE
Bremerton WA 98 37 New use aattechmenn forms TOTAL FEES ft TAX
$
mamma Of LaoALtio4cA
. JES CONiDIX FOR (DATE 1 ,• -> �j rrD42O-7S2)
ELIMINATION OF TITLE: G(.f'VLC.t' / �� / i
Anse who knowlnplya se statement of material fast Ised DEALER'S REPORT OF SALE . I PLMCNASE NICE
of a felony.ale upon conviction may be punished a fie of up to 05,000
and/or 10 yews Imprisonment(K•W4E12.2101.100 SOLEMNLY ATTEST I certify that this Information le
UNDER PENALTY OF PERJURY LAW THAT VINE ARE TIE REGISTERED cornet. The vehicle Is clear of TAX JINIDICTIOWTAX IRATE
OW skroud • nNERS OF THIS IS VEHICLEAMD THIS s�ORM1AT ma IL
encumbrances except as shown.
1/ . :•:.:, ...:�OSALtiElAMt<;::•>::• : ....... : ::: � . DIYE Of Oki MIA:INA NA:i:i:i ffi bEXIEea Almiomato'SalATLI RE •....'.
f. 4111614111111-4111% X
�" NyMeaR s.e.aw d al a seF..w 71iv ti
�', ' lit_1_ .� ` JL1 USE TAX EXEMPT err a Inim en er
• �R i�i� �► -�f_ Der.T� 1eq'+"" emery R.e..etlen Rrr.d�n.r.bse«..e.,e.T w..71
F / ; [ COMITY A1W/TOR/AGENTIJCE SING OFFICE APPROVAL:pYef ler use by hi-Agenbj
- '' that the above application appears to have been completed correctly, and the applicant
- has sufficient documentation to proceed with the recording of this form.
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7 RECORDING OFFICE
This form has been recorded in the county records.
RECONIWO NUsSEt:•"::':. ':..:.. ,:' ::.. . ......<r c :a:;;:;; <:36.'d9':'i.c :,;y:.;;,;`? W:::':.`.' . . COLN7r •VOLUME/PANj DATETD•42D.72eANILA M NOME APPVIRMeU'OR Psis I of2