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40 n • <br /> � C 8v,e Si-1 Ve_ <br /> NATURE OF FILING (check all that applies) <br /> 1Q.AggisiviOilAest El Change ownership of i n 'at d oli <br /> 'e,•r• ng ; , 'ea pro.•rty rd R.R •,ing •m ••e \ .t rie •ern'. \ env edt• : .r.ge <br /> er: <br /> APPLICANT INFORMATION <br /> Dealer/seller ❑Lender ❑Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name: CASCADE FACTORY HOMES INC <br /> Address(including city,state,and ZIP): 590 N PACIFIC HWY,WOODBURN OR 97071 <br /> Phone: 503-981-5314 <br /> Email: CASCADE FACTORY HOMES <br /> HOME INFORMATION (*required) <br /> Home ID number(if Intown): DMV X-plate number(if latowt <br /> 1\1E C,Q;513 <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> ['Other: <br /> Manufacturer:FLEETWOOD HOMES Mode1:210EG28483S Year:2022 <br /> Manufacturer serial number HUD number <br /> FLE210OR21-21572A ORE 55(9040 7 <br /> FLE210OR21-21572B ORiE5560 cob <br /> *Number of sections:2 *Square footage:1280 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofing: ARCH SHING *Type of siding: CEMENT *Heating:ELECT *Cooling:N/A <br /> *Date of sale: '7 Jae,laoa *Sales price:$70,430 *Includes land: ❑Yes No <br /> DEALER INFORMATION (if no dealer, leave blank) <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> CASCADE FACTORY HOMES INC MSD-41 590 N PACIFIC HWY <br /> WOODBURN OR 97071 • <br /> 503-981-5314 <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 that the above statement is true to the best of m k wledge and belief,and that I understand it is <br /> made for use as evidence in court and is subject to penalty f ,(e raj <br /> Dealer name(print): Deal ' .tur Date: <br /> CASCADE FACTORY HOMES INC '7).96 /aDaI <br /> TRANSPORTER INFORMA1If• (if not moving, leave blank) <br /> Transporter name: Transporter address and phone: <br /> SUPERIOR HOME TRANSPORT LLC PO BOX 1067 JEFFERSON, OR 97352 <br /> 503-551-3454 <br /> 440-2952(7/I9/COM) Page 2 <br />