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�:;:;°::1:"'.`T°" MANUFACTURED HOME <br />ICEnsim APPLICATION <br />Please check one <br />®TITLE ELIMINATION (Complete all but section 3, below) - <br />TRANSFER IN LOCATION (Complete ALL sections below) <br />REMOVAL FROM REAL PROPERTY (complete all but section 4, below) <br />nEAR MAKE <br />1995 I MARLETTE I "­W T66 <br />Attach a copy of the legal description of your land. It can be obtained from your L <br />Assessor's office or it may be typed or printed on an Additional Attachment Form <br />Manufactured home will be y� AFFIXED REMOVED <br />I certify that the lega' description of the land and <br />Finalize this application with a I <br />mership is true and correct per the real I <br />MBER 5GRATURE <br />X <br />within 10 calendar days of the date Title <br />THE <br />NAME <br />ADDRESS <br />records. <br />BUILOIIVO YCHmn vrrn.r ...•.. •• •-^••-- - <br />I certify that the manufactured home has been affixed to the real property as described, or a building t? <br />permit has been Issued for this purpose and the attachment will be Inspected uel A <br />eLDd orgpleFIon,HONE a DATE <br />NAME 61GNANpFJ11TLE )- D ��� ^tn-ij///O <br />A NO LNNC AREGIS?EREDOWNERS I IfLEGA;OWNERS <br />® © G 1 <br />T. VAUD PIERCE <br />PATRICIA L. PIERCE <br />434 90TH STREET SW <br />EVERETT <br />NAME OF FIRST LEGAL OWNER' <br />NORWEST MORTGAGE INC. <br />P.O. BOX 5137 <br />W— FEES <br />Provide the Waehinglon Driver's License or LD, FILINGFEE <br />card number (PIC) for each owner: <br />..OR.. it the owner is a business. <br />provide the Unified BUS11 ,ss <br />TAPE ZIP CODE Identifier (UBq, found on the <br />WA 98203 business Registration 6 Licenses <br />Document. <br />More than two owners or one <br />lienholder7 Please use attachment <br />....r lie rnDE form(s) aTD-420-732. <br />FF�ROM <br />WINES IA 50306-5137 <br />URE OF LEGAL OWNER INDICATES CONSENT FOR ELIMNATION OF TIiLElREMOVAL <br />REAL PROPERTY. X WAI <br />Anyone who knowingly make5 a false statement of a mete•id tam Is guilty of a felony, and <br />upon convkllm may be punished by a line of up 10 $5.000 Wolof 10 Years IMINIZORment <br />TCW 46A2.210). I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY LAW <br />HANVWE ARE THE REGISTERED OWNERS OF THIS VEHICLE AND THIS INFORMA- <br />TION IS ACCURATE: Cetrr Sam"'(*) A ""a( <br />Ci <br />DEALER'S REPORT OF SALE <br />I Certify the. this Inlormatlon is correct. The vehicle Is cl=ar of encumbrances except as shown. <br />USE TAX EXEMPT Sale to a CeNMed Tribal member on <br />the tes vats (anach notarized statement of deWery) <br />AND SWORN BEFORE ME THIS <br />RA-- * tC ryI <br />couNTYAUDITORiAGENT LICENSING OFFICE APPROVAL: (Nor for use by SUD•agenrs/ <br />( that the above application appears to have been completed col:ectly, and the applicant has <br />Id with the recording of this form. OFFCFNFBOPERATOR NL <br />