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<br /> ief••-•'f,A, Tide Issue Date Odometer Miles . Odometer Status Fuel Type. ON
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<br /> 02.-Jan;2024 0 Exempt • - •.. ,. .. . • - . . . . ::',41.,
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<br /> .I'•W • •• . .• -42 Ark
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<br /> Date of sale
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<br /> Buyer:.:You must apply for title within 15-calendar days of:acquiring the vehicle to avoid a penally::Takepiksign d title.to a
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<br /> .(4 • .•vehicle/Vessel licensing offide With the appropriate feeS: . ••'
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<br /> :1 Legal Owner:To release'Merest,sign below and give this title to the registered owner/transferee or to a vehicle licensing office • WM
<br /> with the proper fee within 10 days of satisfaction of the security interest,or you may be•liable to the owner/transferee.for penalties, .:.V.:',".;
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<br /> 1.,,i.f.1 • Seller:You must complete a Report of Sale and file it With the Department Of LiOOnsrngrtiiin 5 businede days of sale?.. '.... ...:. 11..i.,;:.
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<br /> .1•::!,...,,51 '• File at del.wa.gov or at any vehicle licensing office or county auditor. •:• ...•:"; .':. ...: ....: .::::. -:-
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<br /> ROBERTO QUIROZ MANCILLA Same as Legal Owner Oe..;.
<br /> i'-'z•••1 9960 HIGHLAND DR NE ..
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<br /> i!: I : • MOSES LAKE WA 98637-3453::
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<br /> ./..'i.,A .• Signature of first legal owher r se :all interest in Date •-. .. :.• .• Signature.or iegiStered'owner releases all interest in -.... :i,:' Date ss...:••••''•••::. ,:,. :::. to...i.
<br /> 2 ..the,vehicle described above if sigrtjfig':for a business, . • -:::::' 2; the vehicle described above if sighing for a business, ]... , •:.:' :. :1. •:: :, 1-;g:`::•I
<br /> include business name,signature and title, . •* ' .: •:.. include busiriess:.'patne;signatures and title.
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<br /> ': Signature of second legal owner releases all interest in Date Signature of registered owner releases all interest in Date
<br /> 1 •. the vehicle described above.If signing for.ebusiness, : . ... .. •:..-..... the vehicle described above.If signinglor...ebusiness,..,••••••••:-.••..:...... ..,,k 1_,.st
<br /> ifi%: • include business name,signature and title,: - •• . • •.. .:• .• . .• • include business name gignature,and title.,•••. -,.. •••.. :. .. ••-:. •.ti:, 5
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<br /> :fe.:v.il 1 certf}that the i ecords of the Department of Licensing the persons ..:•' ... . / ,0.-.,. •.: .t.. .....„ , , ... .. .,....,...
<br /> named hereon as registered owner's and legal owners.of the vehicle described, , Director,Department of Licensing . ..,:.- ,. ,: , . ..,
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<br /> Federal regulation and state law require you to state the mileage when transferring ownership if the vehicle is less than 10 years
<br /> , - = old,unless exempt.Failure to complete this statement or providing efalse statement may result in fines and/or imprisonment..
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<br /> i certify,.i.o the best of my knovViedge, the odometer reading is.. 0 .•.. '. .: '::•• ....(notenths) Transfer date / /" :••. ::.:. is,,,,,:.'1,1 i
<br /> k7,,i,.i "i3 -• . ••• •. E •. ,._, : •. ... •• Odometer reading in miles -: ' ••,• •••...' : ' ".: ••••• !•,:c.g.l. ii
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<br /> 1,-4...,•id••-d) - This readMg•is(check•one): Lithe actual mileage of the vohicle in e)scess.o .ii.o:mechanib limits 0 not the actual mileage • s.• s A,1 ,
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<br /> + -1 - Signature of transferee/buyer'.' ' • ' '"' •' .•8igniture of tratiSfaror/Sellei: .:
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<br /> Ttlii;:l c W-•0), PRINTED name of transferee/bUyer . - . '••." . .•••.• `• 7 ...:. PRINTED name of transferor/seller•-•.:•:-: ....••••. :..:„-•-, ,.. .:1;4,5v. I.
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<br /> Address Of trahsferee/buyer • •:. - • -- ' • • Address of transferor/seller • • .' • '• .: •:: •.'" •: l'iP q
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<br /> TDL7 20-002(13,3:23) .
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