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11/23/2020 07:11AM ` 503824240 AHB AIPAGE 01/06
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<br /> ❑■ DeaIer/seller 1 ❑Lender I ❑ Escrow/title agent 1 ❑ Owner/buyer 1 ❑ Legal representative
<br /> Name:ADVANCED HOME BROKERS, INC.
<br /> Address(including city,state,and ZIP):10762 SE HWY.212 CLACKAMAS. OREGON 97015
<br /> Phone:503-650-0304
<br /> Email:john@a-h-b.com •
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<br /> Home ID number(if known): DMV X-plate number(if known):
<br /> 116133
<br /> Moving in from another state
<br /> Has no home ID or X-plate because: ['Coming out of county deed records
<br /> ri Other:
<br /> Manufacturer:FLEETWOOD 1 Model:WAVERLY CREST 1 Year:1997
<br /> Manufacturer serial number 1 HUD number
<br /> WAFLV31 A14903W C13
<br /> WAFLV31 B 14903WC13
<br /> WAFLV31 C14903WC13
<br /> *Number of sections:3 1 *Square footage:2040 1 *Number of bedrooms:3 1 *Number of bathrooms:2
<br /> *Type of roofing:COMP 1 *Type of siding:T-1-11 1 *Heating:ELECTRIC 1 *Cooling:NONE
<br /> *Date of sale:11-17-2020 L* 1es price:$39,950.00 ` *Includes land:[]Yes 0 No
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<br /> Dealer name: Dealer license number: Dealer address and phone:
<br /> ADVANCED HOME BROKERS, INC. MSD-579 10762 SE HWY.212
<br /> CLACKAMAS. OREGON 97015
<br /> •
<br /> 503-650-0304
<br /> This manufactured structure is free and clear of all mortgages,deeds of trust,security interests,and liens.I have the
<br /> legal right to sell this manufactured structure.
<br /> I hereby declare thatthe above statement is true to the b of my knowledge and belief,and that I understand it is
<br /> made for use as evidence in court and is subject to pena ; for perju7;.
<br /> Dealer name(print): _ D. . e sig.'aturi Date:
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<br /> Transporter name: Transporter address and phone:
<br /> CT WILSON PO BOX 652
<br /> LYLE,WASHINGTON 98536(541)980-5711
<br /> 440-2952(7/17/COM) 0Page 2
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