Repossession Affidavit
Repossession Affidavit
Lienholders use this form to report repossession of a vehicle or vessel. Take this completed form and a Vehicle Title Application or Vessel Title Application to any vehicle licensing office.
Vehicle/Vessel information
License plate/Registration number
Vehicle identification number (VIN) or Hull identification number (HIN)
Model year
Make
Model
Legal owner I,
Name of legal owner or financial institution representative
of Washington, that I am the
Title or position (if applicable)
of
Name of company or corporation (if applicable)
located at
Individual, company, or corporation address
declare under penalty of perjury under the law
We are the legal owners of this vehicle/vessel now in our possession due to a default on a security agreement.
We legally repossessed this vehicle/vessel on
,
Date of repossession
from
,
Name of registered owner
at
.
Address of registered owner
Attached is a transfer of ownership (Vehicle Title Application or Vessel Title Application). We base this on the repossession of the vehicle or vessel.
Date and place (city or county) signed
X Print completed form and sign here.
Signature of legal owner or financial institution representative
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
TD-420-042 (R/8/18)WA
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