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