|
asA 4 s �P-I .IC �� LYDr1 �� oLvn fru V s 3 vv
<br /> ,tgeogisvatr.L.���"!�h}� j}}i x� > a :u��C r ;+ �r,µk �-�i rar t c. s' w�.�'-3.•L S ur -H w>ca zR r�� -+ # r v.
<br /> L,N -. ,t aitt t tr (LItVG igtogh their appiR F,t s ''-ir rr + � , �' r
<br /> . v ....�!t,v -r;r:�;�r:. .4 , .•..;�s ..,.,,;,a, .,..a..,.„ .:bc .:�m ?F., r „ ��ru u4f
<br /> CSAa gt e e uC it 3+11.t64 t Q Change ownershipmo ion Da of o ' o
<br /> �/ R in as rea roeqy '.:n. ing on --al p ..e • .ti - ► ri. •-rm. I! on • e. . • .
<br /> Cfith.er:
<br /> /r' U.a sv,
<br /> �i�'i? , �Y J• AEC?YlJ�pa P't�"{T¢:(jFri f[Tt�o��rr..SFx�,7hYj7x[rG' �' a ti < "•F nt..-.,nr«•--I�Y i$ i o1 -��L�3-s S t-a o
<br /> k;n*c'+i 7r! A,tc ��� tl ^ z�'.imY��e... ? t'r' }t,y�APrPT CAN1` I00#111A0.0g istg 7 a rFrrr #f Jzi� # r. .: ! ;
<br /> -.. ... ..��.. �.. •:,^f^ d ..1'� . .. , t Lir•. ..
<br /> El Dealer/seller ❑Lender (❑Escrow/title agent I ❑ Owner/buyer I ❑ Legal representative
<br /> Name:Factory Expo Homes
<br /> Address(including city,state,and ZIP):2555 Progress Way,Woodburn, OR. 97071
<br /> Phone:503-981-0770
<br /> Email:moconnell@factoryexpohomes.com
<br /> {JSirspl "7r Y[�5'Sv ':el.JS rr^'�KP y, +�".x? a e r r r ,-r 4 h x ¢irak,A .,...,v'< {v r �t t �. aYs.z7 �7
<br /> ,�Mt�,x 'S" 3:41 znr�,s< 1101.4, 'ORt11U `I•iO,0-10,+�q�iR ; ,,k a .���E� ��u a
<br /> o-c sr �.. , ,r._. F. . -... .,x .. - 1� ,6 ,u.i •--�yt,.rb,� ...,r '�?; 3 �.a r '
<br /> Home ID number(if known DMV X-plate number(if known):r
<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 J Model: Oakland 40644G Year: 2022
<br /> Manufacturer serial number. . HUD number
<br /> FLE2100R21-21967A
<br /> FLE2100R21-21967B .
<br /> FLE201 OR21-21967C
<br /> *Number of sections: 3 I *Square footage:2497 I *Number of bedrooms: 4 *Number of bathrooms: 3
<br /> *Type of roofing: Arch. Comp.! *Type of siding: Vert. Cement I *Heating: Electric I *Cooling: None
<br /> *Date of sale: 11/15/2020 *Sales price: 164,248.99 I *includes land: ❑ Yes XNo
<br /> t/�lr rL�r,s a�<E..ry�,y nt4ri}i�``{ll t Jx �.. �, p L -5 7 tr}, F<:r. i1a � -Y '"(„ � tt ' 6i..{r _.
<br /> r �a ; , ' DEALEf 114 CSRMIAi fieri ifWa drealer lease blah /~ t`T.
<br /> J,t 1i"v § u>f Y '
<br /> ... .•._,,,.. r,9.•,.... ,Jz c.'+T', ?t.... ,n o , , f
<br /> Dealer name: Dealer license number: Dealer address and phone:
<br /> Alta Cima Corp. MSD 448 2555 Progress Way
<br /> Dba: Factory Expo Homes Woodburn, OR. 97071
<br /> •
<br /> ElThis 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 name(print): l Dealer signature: Date:
<br /> Alta Cima Corp. 7/ D'eow.friAde 10/25/2021
<br /> fft r srurr� --i cr f � � ,•3 y r<..� r�� r-�,,1.t : � v#'. h,•�.} r t d"'`+ rt-:
<br /> {5;� ', r 41 MNr�`Mr,�y TRA IS OiRTER4NECIR ATION (tf rtdt mv�riti leave blank$ r ;
<br /> :^;; r � ,,.,f.,..s!!rxa 'Fn,�7.�..Y.t,..r ,,<<. :.t..,.ta-hr.x�b,..<<,.i..� ,, I.T,S:G_.:^+•,.�f.. }.„ws, " s. ,.n
<br /> Transporter name: Transporter address and phone:
<br /> Superior Home Transport, LLC PO Box 1067
<br /> Jefferson, OR. 97352
<br /> 440-2952(7/19/COM) Page 2
<br />
|