Abandoned Vehicle Affidavit of Sale (Registered Tow Truck ...
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Abandoned Vehicle Affidavit of Sale (Registered Tow Truck Operators Only)
Registered tow truck operators (RTTO) use this form as an affidavit of sale of an abandoned vehicle. ? TYPE Section 1 RTTO information and Section 2 Vehicle information. ? An application for title, in the purchaser's name, must accompany this affidavit; it must be filed within 15
days of sale. ? Wreckers and salvage processors may use this form as a title on monthly reports if they have acquired the
vehicle from an RTTO or a licensed hulk hauler. ? If the RTTO retains the vehicle, you must apply for a title in the company name within 45 days. ? If you cannot locate the Vehicle Identification Number (VIN), contact your local law enforcement agency to
inspect the vehicle and fill out the "Law enforcement use only" section below. ? Send completed forms to:
Email: DVRCustomerRecordSupport@dol. Fax: 360.570.7876 Mail: Abandoned Vehicles, Dept of Licensing, PO Box 9040, Olympia, WA 98507-9040
1?Registered tow truck operator information
TYPE Name
10-digit phone number 10-digit fax number
Address
City
State
ZIP code
Date stored
Date abandoned
Report date
RTTO number Police agency storing
2?Vehicle information
TYPE Vehicle Identification Number (VIN)
Year
Make
Model
Body style
Plate/tag/decal number State
Type
3?Affidavit of sale?Complete this section for use as an ownership document when yCATMOorhuutouahottbicsoeloikermelrsreec(l/olsyMoonbcnoilrfleegwdimhsopomboieslee, eotfct)he vehicle
Purchaser name
Purchaser street address
City
State
Date of sale
Driver license or UBI number
ZIP code
Total lien (less sales tax) . $ No bid
Sale price . . . . . . . . . . $ Tax . . . . . . . . . . . . . . . $ Amount collected . . . . $ Surplus amount . . . . . $ Date surplus amount sent to DOL
Answer the following
Vehicle purchased for resale?
Reseller permit number
Yes No
4?Certification I declare under penalty of perjury under the law of Washington that the foregoing is true and correct.
Mail surplus funds within 30 days to: Department of Licensing Revenue Accounting PO Box 35001 Seattle, WA 98124-3401
Date and place (city or county) signed
X RTTO: Print completed form and sign before a notary or vehicle licensing agent.
Authorized RTTO 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
(Seal or stamp)
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/office number or notary expiration date
Law enforcement use only
Date
Inspected VIN number
PRINT or TYPE Inspector name
Agency/badge number
DOL use only
Reject
Inspection Unable to locate
RCW 46.55, WAC 308-61
TD-420-550 (R/9/21WA
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