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1QN <br /> Qyy-, LyLn s <br /> :..... ,- TU E OF FILING`ch"eck:al :ttiat.:a lesx.: <br /> LISA e s} situ .. .s. Y; []Change ownership tei—k/ a1 gr ae,rlo r' if ,„. <br /> e or rea fccert e o ro al s a IN •• •et•tV151-C-onivertetl-to-storage <br /> C her: <br /> - ON <br /> _ - •.ORMATI <br /> �A <br /> ..._.-....... . •,•�.:...... .........:.�.''• .,. .. ...,.-r. . r....-.,:.-.....:,tis <br /> ❑Dealer/seller ❑Lender U]Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name:OREGON ESCROW SERVICES <br /> Address(including city,state,and ZIP):PO BOX 2062 EUGENE, OR 97402 <br /> Phone:541-530-0001 <br /> Email:INFO@OREGONESCROWSERVICES.COM <br /> +f=.- HOIVIE'INFORMATION� •ire uireci -.��,.�. <br /> Home ID number(if known): DMV X-plate number(if known).: ` <br /> Dc41,0B <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> 0 Other:NEW HOME <br /> Manufacturer:PALM HARBOR Model:310HD30603D Year:2022 <br /> Manufacturer serial number HUD number <br /> PHH3100R21-14709A ORE 556390 <br /> PHH3100R21-14709B ORE 556391 <br /> *Number of sections:2 *Square footage:1800 *Number of bedrooms: 3 *Number of bathrooms:2 <br /> *Type of roofing: ARCH *Type of siding: FIBER CEM *Heating: ELECTRIC *Cooling: NON <br /> *Date of sale: OCT 21,2021 *Sales price:64,600.00 *Includes land: ❑Yes 0 No <br /> MION" i 'o:�d 'ler-.lea a bla k• - � �� <br /> `DEALER'INFOR A'f f.n _a <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> HOMES DIRECT OF OREGON LLC MSD 523 3838 PALM HARBOR DR NE <br /> MILLERSBURG MILLERSBURG, OR 97321 <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 name(print): Dealer si:s atur : -c_ <br /> HOMES DIRECT OF OREGON LLC MILLERSBURG G�'L G�1 l//G/�� 11/�/ca( <br /> TRANSPORTER.INFORMATION:(if naf movinleave blank = <br /> Transporter name: Transporter address and phone: <br /> 440-2952(7/19/COM) Page 2 <br />