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Get Td420 074 2013-2024

E. Submit this completed form to: Insurance Destroyed Desk Department of Licensing PO Box 9038 Olympia, WA 98507-9038 This form is not valid unless fully completed. Vehicle information Plate number State Vehicle identification number (VIN) Model year Make Model Registered owner name Address City State ZIP code State ZIP code Legal owner name (Enter “SAME” unless different from registered owner) Address City Status   Retained by owner    Retained by insurance comp.

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