Vehicle Title Application Vehicle identification number (VIN)

Additional Owners
Registered owners –Washington primary residence street address or Washington principal place of business street
address is required on the vehicle record. For exceptions, see Primary Residence Address Exception, form 420-004.
Owner type ID type Driver license/ID/TIN/EIN/UBI number Expiration date (Area code) Phone number
3 Choose one
21Choose
- Business
Individual
Registered onefull name
owner 4321 - (Last,
Driver
Tax
Employer
Unified
ID license/ID
no
business
First,ID no no
Middle, Suffix) or Business name

Owner type ID type Driver license/ID/TIN/EIN/UBI number Expiration date (Area code) Phone number
4 Choose one Choose one
21 - Business
Individual
Registered 4321 -name
owner full Driver
Tax
Employer
Unified
IDlicense/ID
no
business
(Last, ID noMiddle,
First, no Suffix) or Business name

Owner type ID type Driver license/ID/TIN/EIN/UBI number Expiration date (Area code) Phone number
5 Choose one
21Choose
- Business
Individual
one
Registered 4321 -name
owner full Driver
Tax
Employer
Unified
IDlicense/ID
no
business
(Last, ID noMiddle,
First, no Suffix) or Business name

Owner type ID type Driver license/ID/TIN/EIN/UBI number Expiration date (Area code) Phone number
6 Choose one
21Choose
- Business
Individual
one
Registered 4321 -name
owner full Driver
Tax
Employer
Unified
IDlicense/ID
no
business
(Last, ID noMiddle,
First, no Suffix) or Business name

Owner type ID type Driver license/ID/TIN/EIN/UBI number Expiration date (Area code) Phone number
7
21Choose
- Business
Individual
one
Registered 4321Choose
owner full -name
Driver
Tax
Employer
Unified
ID
one
license/ID
no
Business
(Last, ID noMiddle,
First, no Suffix) or Business name

Legal owners/Lienholders
Name of legal owner/lienholder (Last, First, Middle initial or Business name)
2
Legal owner/Lienholder type ID type Driver license/ID/TIN/EIN/UBI number Expiration date ELT participant
Choose one Choose one Yes No
21 - Business
Individual
Mailing address (Street address 4
321or-PO
Driver
Tax
Employer
Unified
IDlicense/ID
Box, no
business
ID
City, no no
State, ZIP code)

Name of legal owner/lienholder (Last, First, Middle initial or Business name)

3
Legal owner/Lienholder type ID type Driver license/ID/TIN/EIN/UBI number Expiration date ELT participant
Choose one Choose one Yes No
21 - Business
Individual
Mailing address (Street address 4
321or-PO
Driver
Tax
Employer
Unified
IDlicense/ID
Box, no
business
ID
City, no no
State, ZIP code)

Anyone who knowingly makes a false statement may be guilty of a felony under state law and upon conviction shall be punished by a
fine, imprisonment, or both. I declare under penalty of perjury under the law of Washington that the foregoing is true and correct.
X Registered owner 3: Sign here, include title if business. Enter date and place (city or county) signed.
Signature of registered owner Title, if signing for business Date and place (city or county) signed
X Registered owner 4: Sign here, include title if business. Enter date and place (city or county) signed.
Signature of registered owner Title, if signing for business Date and place (city or county) signed
X Registered owner 5: Sign here, include title if business. Enter date and place (city or county) signed.
Signature of registered owner Title, if signing for business Date and place (city or county) signed
Registered owner 6: Sign here, include title if business.
X Enter date and place (city or county) signed.
Signature of registered owner Title, if signing for business Date and place (city or county) signed
X Registered owner 7: Sign here, include title if business. Enter date and place (city or county) signed.
Signature of registered owner Title, if signing for business Date and place (city or county) signed

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)
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
TD-420-001A (R/5/19)VWA