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1 a 'a.35 No`rAt) F. ,,,-,K i-n S' <br /> DCh se tke'st Change ownership -_.- .z _. <br /> - I z o,. <br /> `` l propely status f Trip permit [1¢ torage <br /> — Other: <br /> aPPL,OCQ`�9`i <br /> [� Dealer/seller __s <br /> ®Lender D Escrow/title agent _:, <br /> Name: �,, Ala. ®•Owner/buyer ® Legal representative <br /> kart Lc.',-; • 4 e LLC- <br /> Address(including city,state,I and ZIP): �,�' d/ . <br /> Phone: - 41- � � � W 11eL' S-�. " C$�bt.-5);1 e :)� 7� <br /> iao <br /> Email: <br /> Home ID number(ifknown)o P®gM6P® I�_ <br /> Q DMV X-plate number(if known): <br /> C� 6)0QDC) <br /> 0 Moving in from another state <br /> Has no home ID or X-plate because: ®Coming out of county deed.records <br /> ®Other: <br /> Manufacturer: F\ <br /> C _ Model: <br /> Year: I•Ct 2 5 <br /> : ...Kanuffetunen serial ri;aa,coberr <br /> MED number <br /> J - <br /> t )-fl-- 31 iri ` A- ' <br /> - 13 <br /> *Number of sections: ,� <br /> Square footage: j f` , *Number of bedrooms: <br /> * � �� ``Number of bathrooms: a. <br /> Type of roofing: `Type of siding:!► � � � [ ' *Keating: t,��"�: *Cooling: <br /> ''Date of sale: q— 7-- D a ( *Sales price: <br /> 0 ?JD COO 'Includes land: 05tes <br /> DEABLEIMINFORNATOOK Of <br /> r© de�dmpg.Ie v bflawiz). <br /> Dealer name: Dealer license number: _ - _ '- - __.__ _ _r <br /> .�\\ c S IA��1a-c-k+ � � Dealer address and phone: I- � .- 64- <br /> s 9D SI-$ I n s t ���,, -� SCS <br /> `eek ---(- ay) , 029735z- <br /> 0This manufactured structure is free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> legal right to sell this manufactured structure. I have the <br /> Jr hereby declare that the above game%$is$a•aae$®the hest of:.r: <br /> and is sanIlD,lectt to penalty for er.uIlcan®vvIledge mud belief,and that Jr aaaader§$am�i it is <br /> made for use as evidence i i court <br /> Dealer name(print): �' I a'S', <br /> i D signature: t <br /> eDA A. 1ajDate: <br /> iiv Li-7_.- _ <br /> � ,IRANSO3T lO �ATOL� Qu?'r © m©dwgo ��d� Q�m �. .Transporter name: <br /> Transporter address andhones <br /> P�\\ Ske�� V v C me- Se�v�;ces 1-1,1,),5-- Gk. Q�- <br /> �ak`aS, oiz li338 <br /> 503 - Co 23 -0989 <br /> 440-2952(7/17/COM) <br /> Page 2 <br />