Vehicle/vessel Disclosure Request Form - Department Of Licensing Public Disclosures
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2Vehicle/Vessel Disclosure Request
We will only release personal, identifying information to you, as allowed by Washington State and federal laws,
to complete work in the normal course of your business or for the completion of a licensing or titling transaction.
Please complete the form and sign on page 2. Use additional sheets if necessary.
Click Here to Start, Then Tab From Field to Field
RESET
Please print or type
Company and/or individual name
(Area code) Telephone number
Mailing address (Street or PO Box, City, State, ZIP code)
(Area code) FAX number
1. Type of information or specific record(s) requested:
If the request is for a specific motor vehicle/vessel/mobile home, please indicate:
Plate/Registration number_________________VIN/HIN number ________________________________
Make/Model/Year_______________________ Mobile home size_________ Location _______________
Possible registered owner name _________________________________________________________
2. Explain in detail, the reason(s) you need the information and how you will use it:
3. If the vehicle/vessel/mobile home is in your possession, how did you obtain it?
4. Will you give the personal record information to anyone else?
No
Yes (If Yes explain WHO and why)
5. Will you contact the owner(s) of record?
No
Yes (If YES explain how and why)
The Department of Licensing has a policy of providing equal access to its services.
If you need special accommodation, please call (360) 902-3600 or TTY (360) 664-8885.
TD-420-531 (R/11/07)W Page 1 of 2
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