Form TD-420-040, Affidavit of Loss/Release of Interest – Washington

The Affidavit of Loss/Release of Interest is a Washington State Department of Licensing (DOL) form on which you swear that vehicle or vessel documents or plates are missing, or give up your interest in a vehicle or vessel, under penalty of perjury under Washington law.

The form identifies the vehicle or vessel by license plate or registration number, Vehicle Identification Number (VIN) or Vessel Hull Identification Number (HIN), model year, make, model and body style. It then has two separate sections, each with its own signature requirement:

• Affidavit of loss. You check what you do not have (title, registration, tab, decal, plates, metal tag) and why it is not in your possession (destroyed, illegible, lost, stolen, or defaced and can no longer be used).
• Release of interest. You check what you are releasing for the vehicle or vessel described above: ownership, gross weight license or personalized plate.

Each section has room for two signers. A business signer gives position and company name and states that they have full authority to sign. The last block, Notarization / Certification, is completed by a notary or a vehicle licensing agent, not by the signer. The printed identifier on the form is TD-420-040 (R/3/18)VWA.

Anyone who must tell DOL that a document or plate for a vehicle or vessel is not in their possession uses the affidavit of loss section. The form lists the items: title, registration, tab, decal, plates and metal tag. It also lists the reasons: destroyed, illegible, lost, stolen, or defaced and can no longer be used.

Anyone who is giving up an interest in a vehicle or vessel uses the release of interest section. The form lists what can be released: ownership, a gross weight license or a personalized plate.

Other points from the form:

• Each section has two signer columns, so more than one person can sign the same section.
• If you sign for a business, you must have full authority to do so, and you enter your position and company name.
• Signers give a Washington driver license number in the space provided, along with phone number and email.
• Your signature must be notarized or certified. If you sign in front of a Washington vehicle licensing agent, the agent can certify it and no notary is needed.

Complete this form when a title, registration, tab, decal, plates or metal tag for a vehicle or vessel is not in your possession, or when you need to release interest in ownership, a gross weight license or a personalized plate for that vehicle or vessel. The form prints no deadline of its own and gives no processing time. It accompanies the vehicle licensing transaction that needs it, so it is submitted when you take or mail that transaction to a vehicle licensing office. Do not sign it ahead of time: the signature must be made before a notary or a vehicle licensing agent, and the date and place of signing are entered on the form.

When the form is completed, you can take it to any vehicle licensing office or mail it. The form prints no mailing address.

• In person: take the completed form to any vehicle licensing office and sign in front of a Washington vehicle licensing agent. The agent can certify your signature, so you do not need a notary.
• By mail: if you mail the form, your signature must be notarized. Sign before the notary, who completes the Notarization / Certification block (state, county, date, name of the person signing, seal or stamp, signature, printed name and notary expiration date).

DOL's forms page recommends downloading PDF forms to your computer and opening them in the latest Adobe Reader before filling them out, because completing them in a web browser can cause formatting issues. FillingPDF lets you fill out and download the PDF; submission follows the channels above.