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2. General Information
4. Contact Person:*
5. Telephone:*
7. E-mail Address:*
8. Today's Date:*
   Today's Date:
10. Landowners Mailing Address:*
11. City:*
13. State:*
14. Zip:*
16. Street Address Where RV / Boat is Located:*
17. City:*
19. State:*
20. Zip:*
22. RV / Boat 1
24. License / Boat Number:
25. State:
27. Year:
28. Color:
29. Make:
31. Vehicle Identifaction Number:
32. Certificate:
    -- Select One --TitleAffidavit in Lieu of TitleJunk Vehicle Affidavit (JVA)
34. Comments or Additional Information
36. RV / Boat 2
38. License / Boat Number:
39. State:
41. Year:
42. Color:
43. Make:
45. Vehicle Identifaction Number:
46. Certificate:
    -- Select One --TitleAffidavit in Lieu of TitleJunk Vehicle Affidavit (JVA)
48. Comments or Additional Information
50. RV / Boat 3
52. License / Boat Number:
53. State:
55. Year:
56. Color:
57. Make:
59. Vehicle Identifaction Number:
60. Certificate:
    -- Select One --TitleAffidavit in Lieu of TitleJunk Vehicle Affidavit (JVA)
62. Comments or Additional Information
64. Additional Information
66. Comments, Directions, Etc.
68. If you have any questions please contact the ECUP team at (425) 388-7613.
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70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit

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