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<br /> N,� . e T s , -st 0Change ownership [I . o, � {, �': ,.'
<br /> ii -r: ! Trip permit „ le
<br /> s mss.l....clithtii 'aei [ O
<br /> ��� DealeP/S01ie�' .�F '' ^ ` __ ..., r � fi ,.j:��4ii�nl..,r<��
<br /> 0Lender ❑Escrow/title agent ❑Owner/buyer
<br /> Name: /).)1 eY ❑Legal representative
<br /> M . . .;r, OA i LLC
<br /> Address(including city,state,and ZIP): i
<br /> Phone: 5 I-GLo(`C7�-C� O �Cr _ - ,T- I
<br /> Q e �35�
<br /> Email! alkuct.. Sty\
<br /> t��.�� -'{y:;,�]� � .�_ °,ate ' t ,C earn
<br /> : }`ti'Yy'F� �"*„ "�7:1:1'., Z•1:'
<br /> a _7 1 ®Sz' 4_7,' z
<br /> Home •
<br /> umber i own): 8 _� °� 's t '`G
<br /> DMV X-plate number(i known): a
<br /> -ao q Pi. ....., boo --7
<br /> 5'. --
<br /> El Moving in from another state
<br /> Has no home ID or X-plate because: fig Coming out of county deed records
<br /> 0 Other:
<br /> Manufacturer. SK ,t l n.2.r. _
<br /> Model:
<br /> = .=.� nuf�cturer.- 1 Jthn ber Year: /. �
<br /> EVLIARmiler
<br /> . -2 5 v 6-22 Dhl
<br /> *Number of sections:
<br /> * *Square footage: )/73 *Number of bedrooms: N
<br /> Type ofroofmg; CA 3 umber of bathrooms:,�
<br /> 7n a *Type of siding:T/// t re, r.
<br /> o�, Heating: �lGc�1 t • I
<br /> *Date of sale: o *Cooling;
<br /> 3 dd� *Sales price:. D� *Incl
<br /> t_> ' #�. .: :�,� � � � .��� *Includes land:❑ �N
<br /> �. . � .,�,x z.. � `_Y•41011: �R 11hIFO r� ,:r . _ Yes o
<br /> _, . �,, 110010Str�if�no dial® � - _ is
<br /> De ler �: ••e. '- ��_�.�.��....,��rle8VE8 618p11��� . yam. � - -��,
<br /> Dealer _a=- L.v= , ��F ,t'p'
<br /> Dc y s May,tv/aynt- c(--twed license number:
<br /> Ti yet Dealer address
<br /> �byY1L n AA 3 b S z4 ( �► 0� 1 r_ and phone:T
<br /> LLC, (0 ►ry Sfi
<br /> 3-'- so ' C X7352.
<br /> ❑This manufactured structure is free and clear of all modeeds-of5�I -�c Ca G ~a 0
<br /> legal right to sell this manufactured structure. mortgages, trust,security interests,and liens.I have the
<br /> I hereby declare that the above statement is true to the best of my knowledge and belief,and that I
<br /> made for use as evidence in court and is subject to penalty for perjury,
<br /> understand it is
<br /> Dealerpname(print):
<br /> r'I I Wa(s kn .ehttoi V3 net Mature: ' /�� � ,
<br /> C t a^ �„Z..�, �' 7- F, Ll V4 VV IUV3
<br /> �T ortername: els"- 4, � T � j ►`�1.�,J It �iiA rrr.:�i0114rit! t n r 3.;„24„2/``.
<br /> �t_ � Y 1 / test r r
<br /> Phil5 e�ri i • I YIE'. >>�(UI C�E' Transporter address and h ne; ,,. a c�, , ,
<br /> ' s tnc,. v-1Q05 . R. bcdlcis 02 9'73
<br /> J
<br /> 503 - 62.3 - to9gal
<br /> 440-2952(7/17/COA)
<br /> Page 2
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