Vehicle Title Application

X X

Notarization / Certication – You don’t need your signature notarized if you sign in front of a WA vehicle licensing agent, who can certify your signature.

State of County of

Signed or attested before me on by

Name of person(s) signing this document

Notary/Agent/Subagent signature

Notary printed or stamped name

Title and

Dealer or county/oce number or notary expiration date

(Seal or stamp)

Vehicle Title Application

Permit number

Vehicle – Please type or print plainly Lease Plate transfer: number Title purposes only

Vehicle identication number (VIN) Condition Vehicle type Primary use type Fuel type

New Used

Model year Make Model Trim Body style Motorcycle style

GV weight rating Scale wt Gross weight Mo GWT Seats Trl axles Color #1 Color #2 Equip number Purchase price

Wheels Rental number Fleet Engine (MC) Motor home/Cycle/WATV eng serial no Length Width Quick title Discover pass Park donation

Yes No Yes No Yes No

Registered owner

– For additional owners, see Vehicle Title Application Additional Owners, form 420-001A. Washington

primary residence street address or Washington principal place of business street address is required on the vehicle record. For

exceptions, see Primary Residence Address Exception, form 420-004.

Owner type ID type Driver license/ID/TIN/EIN/UBI no Expiration date Phone type (Area code) phone number

Registered owner full name (Last, First, Middle, Sux) or Business name

Washington primary residence address (if an individual) or Washington principal place of business address (if a business)

Mailing address, if dierent than residence address (Street address or PO Box, City, State, ZIP code) or exception address

One-time mailing address, if applicable

Email address Paperless renewal option

Notify me by email when it’s time to renew my vehicle

Owner type Ownership–Joint tenants w/right ID type Driver license/ID/TIN/EIN/UBI no Expiration date (Area code) phone number

of survivorship

(JTWROS) Yes No

Registered owner full name (Last, First, Middle, Sux) or Business name

Legal owner/Lienholder* – Fill out if dierent than registered owner. For additional legal owner/lienholders, see Vehicle Title

Application Additional Owners, form 420-001A. *Approved lienholder may be added by selling dealer at a later time.

Name of legal owner/lienholder (Last, First, Middle initial or Business name)

Legal owner/Lienholder type ID type Driver license/ID/TIN/EIN/UBI number Expiration date ELT participant

Yes No

Mailing address (Street address or PO Box, City, State, ZIP code)

Dealer

Dealer type Dealer no Dealer name Sale date Delivery date Vehicle status

New Used Prev titled

Dealer 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 ne,

imprisonment, or both. I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.

Signature of registered owner Title, if signing for business Signature of registered owner Title, if signing for business

Date and place signed Date and place signed

TD-420-001 (R/5/19)VWA

I certify that this information is correct. The vehicle is clear of encumbrances

except as shown. Any required sales tax has been collected.

Choose one

1 - Automobile2 - Truck3 - Motorcycle4 - Mobile/Mfg home 5 - Trailer6 - Other

Choose one

1 - Passenger vehicle2 - Antique vehicle3 - Commerical4 - Exempt (st/co/loc/tribal)5 - Farm exempt6 - For hire7 - Gov't (federal)8 - Med-speed electric9 - Neighborhood electric10 - Off-road vehicle11 - School (private)12 - Stage13 - Taxi cab14 - Truck16 - Combo (farm use)17 - Combo (non-farm use)21 - Farm use22 - Fixed load vehicle25 - Logging27 - Motorhome32 - Tow truck33 - Motorcycle39 - Mobile home42 - Com'l motorcycle trailer46 - House dolly48 - Trailer (personal use)49 - Travel trailer50 - Travel trailer (antique)51 - All terraine veh (WATV)52 - Camper53 - Converter gear55 - Mid-elect truck56 - Mid-elect vehicle57 - Moped61 - Snowmobile62 - Snowmobile (exempt)63 - Snowmobile (vintage)

Choose one1 - Gasoline2 - Diesel3 - Electric4 - Hybrid5 - Comp natural gas6 - Liq natural gas7 - Liq petroleum gas8 - Butane9 - Propane10 - Steam11 - Unpowered12 - Other

Choose one1 - 3-Wheel2 - Adventure bike3 - Cruiser bike4 - Dirt bike5 - Dual sport bike6 - Scooter7 - Sport bike8 - Standard9 - Touring bike

Choose one1 - 0-6,0002 - 6,001-10,0003 - 10,001-14,0004 - 14,001-16,0005 - 16,001-19,5006 - 19,501-26.0007 - 26,001-33,0008 - 33,001-99,999

Choose one1 - Beige2 - Black3 - Blue4 - Blue, dark5 - Blue, light6 - Brown7 - Bronze8 - Chrome/steel9 - Copper10 - Cream/ivory11 - Gold12 - Gray13 - Green14 - Green, dark15 - Green, light16 - Ivory17 - Lavender18 - Maroon/burgundy19 - Multicolor20 - Orange21 - Pink22 - Purple23 - Red24 - Silver/aluminum25 - Tan26 - Turquoise27 - White28 - Yellow

Choose one

1 - Individual2 - Business

Choose one

1 - Driver license ID2 - Tax ID no3 - Employer ID no4 - Unified business no

Choose one

1 - Business2 - Cell3 - Home

Choose one

1 - Individual2 - Business

Choose one

1 - Driver license/ID2 - Tax ID no3 - Employer ID no4 - Unified business no

Choose one

1 - Individual2 - Business

Choose one

1 - Driver license/ID2 - Tax ID no3 - Employer ID no4 - Unified business no

Choose one:

In stateOut of state

Dealer signs here

Registered owner 1: Sign here, include title if business

Date and place (city or county) signed

Registered owner 2: Sign here, include title if business

Date and place (city or county) signed