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Get WA DoL TD-420-538 2014

Click here to START or CLEAR then hit the TAB button Adobe Reader XI required to fill out this form Click to download Wrecker/ Scrap Processor Monthly Report Select how you will submit your report. NOTE Reports not submitted electronically require original signature and notary seal* List each vehicle acquired in the previous month. If no vehicles were acquired select none. Reports are due by the 10th of the month following the month the vehicles were acquired* IMPORTANT Keep a copy of the report and all supporting documents verifying ownership at your place of business for 3 years from the date acquired* How are you submitting report Internet Business name Wrecker/Processor license Month/Year vehicles acquired U*S* mail Stock / Yard number Year Make Plate number State Motor or vehicle Identification number Supporting documents Acquired from Acquisition activity None Wreckers only Meets value threshold Yes No Add a page Company email Notarization/Certification State of County of Signed or attested before me on by Printed or stamped name Signature Dealer/county/office or notary expiration date Title TD-420-538 R/12/14 WA Seal or stamp By typing or signing your name you certify that 1 this is a list of all vehicles and vehicle salvage legally acquired during the report month 2 all vehicles and/or license plates listed have been destroyed and 3 all documents verifying ownership for these vehicles have been marked destroyed and will be kept for a minimum of 3 years at your place of business. X Sign your name here before a notary if emailing this form If using Submit to DOL button certify by typing your name. Mailed report - requires signature before a notary public* Mail to Department of Licensing PO Box 9038 Olympia WA 98507. Save Submit to DOL We are committed to providing equal access to our services. If you need accommodation please call 360 902-4019 or TTY 360 664-0116. NOTE Reports not submitted electronically require original signature and notary seal* List each vehicle acquired in the previous month. If no vehicles were acquired select none. Reports are due by the 10th of the month following the month the vehicles were acquired* IMPORTANT Keep a copy of the report and all supporting documents verifying ownership at your place of business for 3 years from the date acquired* How are you submitting report Internet Business name Wrecker/Processor license Month/Year vehicles acquired U*S* mail Stock / Yard number Year Make Plate number State Motor or vehicle Identification number Supporting documents Acquired from Acquisition activity None Wreckers only Meets value threshold Yes No Add a page Company email Notarization/Certification State of County of Signed or attested before me on by Printed or stamped name Signature Dealer/county/office or notary expiration date Title TD-420-538 R/12/14 WA Seal or stamp By typing or signing your name you certify that 1 this is a list of all vehicles and vehicle salvage legally acquired during the report month 2 all vehicles and/or license plates listed have been destroyed and 3 all documents verifying ownership for these vehicles have been marked destroyed and will be kept for a minimum of 3 years at your place of business. .

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