Fillable Printable Vehicle Certificate of Ownership (Title) Application - Washington
Fillable Printable Vehicle Certificate of Ownership (Title) Application - Washington
Vehicle Certificate of Ownership (Title) Application - Washington
Notarization/Certification for registered owner signature
State of , County of
Signed or attested before me on by
(Seal or stamp)
Signature
Printed or stamped name
Title and
Dealer or county/office number or notary expiration date
Fees
Filing
Scale weight
RTA excise tax
License
Application
Inspection
VIN assignment
Gross weight
GWT credit
(Attach proof)
Arbitration
Sales/Use tax
License service
Plate
LPG
Aquatic weed
Trauma
Replacement tab
State parks donation
$5 $0
Out of state
Other
Total fees and tax
Service fee (Do not
include
in total)
X
X
X
Vehicle Certificate of Ownership (Title) Application
Plate or TPO Color #1 Color #2 Vehicle Identification Number (VIN)
Model year Pwr Use Make Series/Body type Model ID Value code Year
Cycle engine or motor home number Fleet code Equip number MO reg Reg exp date Scale weight Seats
Declared GWT Month GWT GWT expiration Mileage Code Previous title number State
County of residence Purchase price Tax jurisdiction Tax rate
For more than two registered or legal owners, please attach additional applications.
New registered owner
Name (Last, First, Middle initial) (Area code) Telephone number
Name (Last, First, Middle initial) (Area code) Telephone number
Washington State primary residence street address (if an individual) or Washington State principal place of business street address (if a business)
Address continued
Mailing address (if different than residence address) or exception address
First owner’s WA driver license, ID card, or UBI Expiration date Second owner’s WA driver license, ID card, or UBI Expiration date
New legal owner or lienholder – must be filled out if different than the registered owner
Name (Last, First, Middle initial)
Name (Last, First, Middle initial)
Address
First owner’s WA driver license, ID card, or UBI Expiration date Second owner’s WA driver license, ID card, or UBI Expiration date
WA dealer number Dealer name Date of sale
Date of delivery Vehicle is:
New Used Previously titled
Dealer’s authorized signature
Anyone who knowingly makes a false statement may be guilty of a felony under state law and upon conviction shall be punished by a fine,
imprisonment, or both. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.
Date and place Registered owner signature Position, if signing for a business
Date and place Registered owner signature Position, if signing for a business
TD-420-001 (R/7/14)WA We are committed to providing equal access to our services. If you need accommodation, please call (360) 902-3770 or TTY (360) 664-0116.
Special options
DAV Leased No title issued
NRM Bonded Non-roadworthy
Native American Reg only
Joint tenants with rights of survivorship
USE TAX EXEMPT: Private automobile was purchased and used by me in another
state for a minimum of 90 days while I was a bonafide resident, before I entered
Washington on
(Must be used in Washington for personal and family transportation only.)
GIFT: Donor previously paid Washington State sales/use tax.
INHERITANCE: Washington sales/use tax paid by testator.
Transferred to SPOUSE.
Sale to INDIAN IN INDIAN COUNTRY. Notarized statement is attached.
Washington State primary residence street address
or Washington State principal place of business
street address is required on the vehicle record.
For exceptions to this rule, see form TD-420-004.
Dealer’s report of sale
I certify that this information is correct.
The vehicle is clear of encumbrances
except as shown. Any required sales tax
has been collected.
