Laserfiche WebLink
1446933 QdVJ <br /> V $L ,SC1 f Y T) 73 <br /> NATURE OF FILING (check all that applies) <br /> NS2 se it er h o ip De ' lon at for •t&ePr <br /> ding r 'I r:p- •� . .R- •. n.: o re: prop- .4,s 1 VTrip permit I Siage <br /> • <br /> then <br /> • <br /> APPLICANT INFORMATION <br /> 0 Dealer/seller 10 Lender Q Escrow/title agent I fl Owner/buyer 0 Legal representative <br /> Name:Joseph Johnson and Sandy Hamilton <br /> Address(including city, state, and ZIP): 700 CORDON ROAD SOUTHEAST SALEM OR 97317 <br /> Phone: so SG q U I <br /> Email: <br /> HOME INFORMATION (*required) <br /> Home ID number(ifknown E SIV) DMV X-plate number(if known): <br /> Q 4 C 4- <br /> U Moving in from another state <br /> Has no home ID or X-plate because: — C°ming out of county deed records <br /> 0 Other: <br /> Manufacturer: CLAYTON I Model: 761G I Year: 2022 <br /> Manufacturer serial number HUD number <br /> ALB040843ORABC <br /> *Number of sections: 3 *Square footage:2Cf 0 I*Number of bedrooms: g *Number of bathrooms: 3 <br /> La <br /> *Type of roofing: ror _s_*Type of siding: P P *Heating: *Cooling: /A <br /> *Date of sale: *Sales price: 261 tut! *Includes land: fl Yes yNo <br /> DEALER INFORMATION (if no dealer, leave blank) <br /> Dealer name: Dealer li - .-- Dealer address and phone: <br /> CLAYTON HOMES ALBANY,OR DLR ##MSD195 <br /> CCB #166990 ', 1437 CENTURY DRIVE NE <br /> ALBANY OR 97322 <br /> (541)967-8555 <br /> f]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 tour Best of 'knowledge and belief,and that I understand it <br /> is made for use as evidence in court and is subjec to penalty : •rjury. <br /> Dealer name(print): DL ler siglxs Date: <br /> C/0tAl l" " ' v`•'' ti)-1-,Le ) r /0 z <br /> TRANSPORTER INFORMATION (if not moving, leave blank) <br /> Transporter name: Transporter address and phone: <br /> Y1Y� ?C)V I' C7��j' M t 17)6 r10 1 253 <br /> 440-2952(7/19/COM) <br /> OR Title Application-10/2019-TitleApp11211 Page 2 <br /> 004481455-00001 <br />