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Affidavit of Loss/  Release of Interest
License/Registration number Year Make Series and body Title number

Vehicle Identification Number (VIN) or Vessel Hull Identification Number (HIN)

Affidavit of Loss

The following is not in my possession because it was lost, stolen, destroyed, or mutilated: (Check the applicable box)    Title    Registration    Tab    Decal    Plate(s) I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. If signing for a business, I have full authority to do so.
Printed name (Position and company name if signing for business) Printed name (Position and company name if signing for business)

WA driver license, ID, or UBI WA driver license, ID, or UBI

X X

When completed, print this out and sign here

Signature

When completed, print this out and sign here

Signature

Notarization/ Certification for Affidavit of Loss
State of Signed or attested before me on
(Seal or stamp)

, County of by

Signature

Printed or stamped name

Title

and

Dealer or county/office number or notary expiration date

Release of Interest

I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. If signing for a business, I have full authority to do so.
Printed name (Position and company name if signing for business) Printed name (Position and company name if signing for business)

WA driver license, ID, or UBI WA driver license, ID, or UBI

X X

When completed, print this out and sign here

Signature of person releasing interest
When completed, print this out and sign here

Signature of person releasing interest

Gross Weight License

I authorize this Gross Weight License to be transferred to the new owner and remain with the vehicle described above.
Printed name (Position and company name if signing for business)

WA driver license, ID, or UBI

X

When completed, print this out and sign here

Signature of person authorizing transfer

Notarization/ Certification for Release of Interest and/or Gross Weight Transfer
State of Signed or attested before me on
(Seal or stamp)

, County of by

Signature

Printed or stamped name

Title

and

Dealer or county/office number or notary expiration date

TD-420-040 (R/5/13)WA

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