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Afdavit of Loss/ Release of Interest

License/Registration number Year Make Series and body Title number

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

Afdavit 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/Certication for Afdavit 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/ofce 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

When completed, print this out and sign here

Signature of person authorizing transfer

Notarization/Certication 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/ofce number or notary expiration date

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

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