Certificate of Fact - Department of Licensing
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Certificate of Fact
Use this form to make a statement of fact.
License plate/Registration number
Vehicle Identification Number (VIN) or Hull Identification Number (HIN)
Model year
Make
Model
I certify that
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
Date and place (city or county) signed
X
Signature
Print completed form and sign here
Printed name of person signing this document
TD-420-043 (R/9/17)WA
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