Laserfiche WebLink
n 13 20,09:45a Dougs Mobile Home Service 503-200-1299 p.1 <br /> . NATURE OF FILING (check all that applies) . _- . . •• .• • <br /> ❑ Change security interest El Change ownership ❑ Demolition Date of demolition: <br /> ❑ Recording as real property Q Removing from real property status # Trip permit ❑ Converted to storage <br /> ❑ Other: <br /> APPLICANT INFORMATION: .- • • ' .. • • - • . • • -- <br /> ❑ Dealer/seller ❑Lender ❑Escrow/title agent LI Owner/buyer ❑ Legal representative <br /> Name:CORDRAY, CYNTHIA -i / <br /> Address (including city,state, and ZIP): 1 I/ 7-57 J VL/ Br/ Gk. I i rd IIS S/i�r vini <br /> l <br /> Phone: 5-0 3-C� 3 y � Z d 4. q"J //— .�,�d <br /> Email: l�k--1 lJ ( (i ii('i co yK) <br /> . <br /> HOME INFORMATION (*required) • <br /> Home ID number(f known): DMV X-plate number(if known): <br /> Nir 1 - X215605 ryv5 m 4 24 <br /> ❑ Moving in from another state <br /> Has no home ID or X-plate because: ,Coming out of county deed records I) - i(-e, ud + / -sd--i <br /> E � <br /> ❑ Other: N'1 40 i�5 <br /> Manufacturer:FLEETWOOD Model: L/1,,j 1.1 3 8 I Year:1992 <br /> Manufacturer serial number HUD number <br /> ORFLM48AB13569GH <br /> *Number of sections:2 *Square footage:1188 *Number of bedrooms: 2 .i Number of bathrooms: 2 <br /> *Type of roofing: 4frts/11} 1 *Type of siding: itis ti t VI *Beating:1-15 41w *Cooling: 4), <br /> i. <br /> *Date of sale: i ,3 _161 *Sales price:- IA ` C A _ *includes land: El Yes 12-No <br /> . DEALER INFORMATION (if'no dealer; leave blank) - <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> r es S Z'i� .6c(e.. tr c� 1 �-6 �� r'Y It s <br /> `��S�,-�, � ��vtis t� 07e.tet'?e. 2_. <br /> SCS. 7,7q --0,3-3 et <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 my knowledge and belief, and that I understand it is <br /> made for use as evidence in court and is subject to penalty for perjury. <br /> Dealer ante(print): Dealer sign' I Date: <br /> •• (if ot movin , leave:blank) - <br /> TRANSPORTER INFORMATION. 9 . . <br /> Transporter name: L ,/. Transporter address and phlone: <br /> 64-0 brie- z.en 3�.^t496 'srace_. /1.q�- !`� ' /(�C[ ,6,--. ,.6-6,.3-7-1V-e--1.5--5g <br /> 440 2952(7119/C0M) Page 2 <br />