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-To 0eaiev's , 1' 35 —Turner a e( OE" <br /> DocuSign Envelope ID:FD02A388-17EA-4860-9C59-B3F3FFB2336F • <br /> IV\Nrek frorr‘ ?0\\<, DccuLv`5 1--- <br /> • <br /> URE•'OF.�FILING. c eak:all.th��•t:a••��lie•', <br /> • .. .... <br /> fjAVIPAriVtaitAttifogenSt ©Change ownership : .• I)a - o de n olitt.n: <br /> or ' re r ex 41040• '.• •• • • •p=•t , .tus ❑Trip permit to oqge <br /> ..:•,.....,,..:..;:...:•..{:.:•:. ,{,;.•,•.:--•,.,�„APPLICANTtN6.0 . ION:::�::�;:•:.:'';:::;:;�:•:::•:��;?:••�`: iso::'.°:;:�' •��':•.,:�;':;'�:�;;:::;:::::: :•;: <br /> r]Dealer/seller ❑Lender ❑Escrow/title agent ❑/ Owner/buyer ❑Legal representative <br /> Name:Factory Homes Clearance Center Inc <br /> Address(including city,state,and ZIP):P 0 Box 2176 Tualatin OR 97062 <br /> Phone:371-224-2244 <br /> Email:janetm@gunnerilc,com <br /> e _ <br /> O O :re ulr ci <br /> ME�INt=. RMATi <br /> N•. <br /> Ileme ID number(if known): DMV X-plate number(if known): <br /> 1-11 41641 • <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> 0 Other: <br /> • <br /> Manufacturer:Fuqua Model:Fuqua Year:1994 <br /> Manufacturer serial number HUD number <br /> 132,324 ORE 362850 <br /> 1 3 2. 3 2 ORE 362851 <br /> *Number of sections:2 *Square footage:1300 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofing:Comp *Type of siding:T11 *Heating:Electric *Cooling:None <br /> *Date of sale: *Sales price:15,000.00 *Includes land:❑Yes IJ No <br /> `��'• ••••�`• -• ••• •• • •. .IV�QRMATIQN if:no:dealer'aeave:titarik <br /> .•. EALER <br /> Dealer name: Dealer license number: ' Dealer address and phone: <br /> • <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 /> T hereby declare that the above statement is true to the best of my knowledge and belief,and that T understand it Is <br /> made for use as evidence in court and is subject to penalty for perjury. <br /> Dealer name(print): Dealer signature: Date: • <br /> �TRANSPO TE�.INFORMATION ifri t.:m•"ovin '' ea e;ht <br /> rit <br /> Transporter name: Transporter address and phone: <br /> Doug's MH Setup&Service 12692 Fry Rd NE <br /> Aurora, OR 97002 • <br /> 503-799-0539 <br /> 440-2952(7/19/COM) Page 2 <br />