Fillable Printable Manufactured Home Application
Fillable Printable Manufactured Home Application
Manufactured Home Application
X
Notarization/ Certification State of , County of
Signed or attested before me on
(Seal or stamp) by by
Print registered owner name Print registered owner name
Notary printed or stamped name Notary signature
and
Title Dealer/ county office number or notary expiration
X
X
X
Manufactured Home
Application
For full instructions on completing this form, see Manufactured Home
Application Instructions, form TD-420-730.
1 Manufactured Home
Title purpose only (TPO)/ Plate no. Year Make Length/ Width (feet) Vehicle identification no. (VIN)
2 Land
Manufactured home will be
Affixed Removed
Real property
Tax parcel no. Legal description on page
Lot Block Plat name or Section/ Township/ Range Quarter/ Quarter section
3 Grantor(s) Registered/ Legal Owner(s) – Additional names on page
County no. No. registered owners No. legal owners Grantee name (if applicable)
Name of registered owner Washington driver license or UBI no.
Name of additional registered owner Washington driver license or UBI no.
Address (Address, City, State, ZIP code)
Name of legal owner Washington driver license or UBI no.
Name of additional legal owner Washington driver license or UBI no.
Address (Address, City State, ZIP code)
I certify under penalty of perjury under the laws of the state of Washington that I am/ we are the registered
owner(s) of this manufactured home and the foregoing information is true and correct.
Date and place (city or county) signed Registered owner signature Title, if signing for a business
Date and place (city or county) signed Registered owner signature Title, if signing for a business
TD-420-729 (R/8/16)WA Page 1 of 3 Continued on next page
Please check one:
Title Elimination
Transfer in Location
Removal from Real Property
RETURN RECORDED DOCUMENT TO:
Click here to START or CLEAR, then hit the TAB button
Print completed form and sign here.
Additional registered owner: Sign here
X
Notarization/ Certification State of , County of
Signed or attested before me on
(Seal or stamp) by by
Print legal owner name Print legal owner name
Notary printed or stamped name Notary signature
and
Title Dealer/ county office number or notary expiration
X
X
X
X
Manufactured home TPO/ Plate number (from Section 1)
4 Title Company Certification
PRINT or TYPE Name of person signing Title company name
Position (Area code) Telephone no.
I certify that the legal description of the land and ownership is true and correct according to the real property records.
Signature Date
5 Building Permit Office Certification
I certify that
the manufactured home has been affixed to the real property as described.
a building permit has been issued for this purpose and the attachment will be inspected upon completion.
PRINT or TYPE Name of person signing Building permit office Building permit no.
Position (Area code) Telephone no.
Signature Date
6 Signature of Legal Owner(s)
Signature of legal owner indicates consent for Elimination of Title or Removal from real property.
Legal owner signature Title, if signing for a business
Legal owner signature Title, if signing for a business
7 Land Description
Legal description of land
TD-420-729 (R/8/16)WA Page 2 of 3 Continued on next page
Title company: Sign and date here.
Building permit office: sign and date here
Legal owner sign here, include title if applicable
Legal owner sign here, include title if applicable
X
X
Manufactured home TPO/ Plate number (from Section 1)
8 Dealer Report of Sale – Selling dealer complete this section
PRINT or TYPE Dealer name Washington dealer no.
Date of sale Purchase price Tax jurisdiction/ Tax rate
Sales Tax Exempt – Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery).
I certify under penalty of perjury under the laws of the state of Washington that this information is correct. The
manufactured home is clear of encumbrances except as shown. Any required sales tax has been collected.
Date and place (city or county) signed Dealer authorized signature
9 County Auditor/ Agent Licensing Office Approval (not for use by subagents)
PRINT or TYPE Name County office/ VFS operator no.
I certify that the above application appears to be completed correctly, and the applicant has sufficient
documentation to proceed with the recording of this form.
Signature Date
10
Title Fees
Filing fee Application Mobile home fee Elimination fee Use tax Subagent fees
Total fees and tax
Anyone who knowingly makes a false statement of a material fact is guilty of a felony, and upon
conviction may be punished by a fine, imprisonment, or both. RCW 46.12.750
TD-420-729 (R/8/16)WA Page 3 of 3
Dealer: When completed, sign here.
When completed, sign and date here.
