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    Vehicle - Vessel Owner Name Update Affidavit For Individual

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    andreaandtommy22

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    © All Rights Reserved
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    Vehicle - Vessel Owner Name Update Affidavit For Individual

    Uploaded by

    andreaandtommy22
    8 views1 page

    Original Title

    Vehicle_Vessel Owner Name Update Affidavit for Individual

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    8 views1 page

    Vehicle - Vessel Owner Name Update Affidavit For Individual

    Uploaded by

    andreaandtommy22

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Vehicle/ Vessel Owner

    Name Update Affidavit for Individual


    Use this form to change your name on your vehicle/vessel record or to state your name as “one and the same” as the
    owner of a vehicle or vessel. When completed, take or mail this form to any vehicle licensing office to process. NOTE: You
    may need to complete additional paperwork.

    Vehicle/ Vessel information


    PRINT or TYPE Vehicle plate/tab/decal or vessel registration number Vehicle Identification Number (VIN) or Hull Identification Number (HIN)
    BBP4094 3VWJM71K19M091451
    Model year Make Model
    2009 VOLKSWAGAN JETTA
    Current name on record
    Current name on record (Last, First, Middle)
    SCHMITZ, ANDREA R.
    Correct a misspelled name
    Correct name (Last, First, Middle)

    Change your name


    Change name to (Last, First, Middle)
    HURSH, ANDREA R.
    Reason for change
    GOT MARRIED 02/22/2002

    One and the same person


    The following names are one and the same person:
    Name (Last, First, Middle)
    SCHMITZ, ANDREA R.
    Name (Last, First, Middle)
    HURSH, ANDREA R.

    I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct and I am
    not defrauding creditors by changing my name.


    SCHMIAR169QS
    Washington driver license/ ID card number

    X
    Date and place (city or county) signed Signature

    Notarization / Certification – 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
    (Seal or stamp)

    Notary/Agent/Subagent signature


    Notary printed or stamped name

    Title and
    Dealer or county/office number or notary expiration date

    WAC 308-56A-315
    TD-420-047 (R/2/18)WA

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