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35 ' ft <br /> NATURE OF FILING (check all that applies) <br /> ❑Change security interest Change ownership ❑Demolition Date of demolition: <br /> ❑Recording as real property ❑Removing from real property status ❑Trip permit ❑ Converted to storage <br /> ❑Other: <br /> APPLICANT INFORMATION <br /> 0 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 known): DMV X-plate number(if known): <br /> 01 CO <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:Skyline Homes Model:1471 CT Year:2022 <br /> Manufacturer serial number HUD number <br /> 245-000-H-A101014A <br /> 245-000-H-Al01014B <br /> 245-000-H-A101014C <br /> *Number of sections:3 *Square footage:2,444 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofmg: ARCH SHING *Type of siding: CEMENT *Heating:ELECT *Cooling:N/A <br /> *Date of sale:12/22/2021 *Sales price:$288,833.75 *Includes land: El Yes 0 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 my knowledge and belief,and that I understand it is <br /> made for use as evidence in court and is subject to penalty,.- perjuoy. <br /> Dealer name(print): D-I eign re Date: <br /> CASCADE FACTORY HOMES INC 12/22/2021 <br /> TRANSPORTER INFO JII'ATION (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(7/19/COM) Page 2 <br />