|
61 ` e— �-'� C 5 . k- 6R__
<br /> X34
<br /> goom✓'.-u"t�'� �} w.:r�..-c7i,�'"{�,.,ai t�i��(,n r A �' ar �s Sv';ti'�. 4r.,.�+h ,�r",.,".
<br /> .4y+ mi r4 dtZ,hrS'ts %« /you ert ergs sciti i $�IIrmva'IG.7� `"'r- °:,v a3" t t+: vm
<br /> / +v R ff4 ria Z` F S' k -
<br /> ... 3#1'-}.F'v�air!t..N.'n..l:si54r.3,r✓..c1�L".r.-J nY.xv Vr,....,-7.-n«.�,". 1f( rt�.i, "��
<br /> ❑Change security interest . 0 Change ownership ❑Demolition Date of demolition:
<br /> ❑Recording as real property ❑Removing from real property status •Trip permit ❑Converted to storage
<br /> ❑Other:
<br /> ¢WWk ,
<br /> MTY,Ai�eNs r ' , taA 1Ef a� k rrp*srr st€r 'zr_ J Y� A +:VAAI M {r . '
<br /> Dealer/seller ❑Lender ❑Escrow/title agent ❑Owner/buyer y El Legal representative
<br /> Name:Factory Expo Homes
<br /> Address(including city,state,and ZIP);2555 Progress Way,Woodburn,OR. 97071
<br /> • Phone:503-981-0770
<br /> Email:moconnell@factoryexpohomes.com
<br /> 3dfi��� ,.s"'�" ' �.�,���xv ,�s,���e7. � ,��%.� �{'��'n:����j c j s'��'�• r r,�.. 7rfa. �s.,,.�.a r - ...aw.s .�k .c^.&,r
<br /> f l a irif �'K�' 4 y,.o t o yt<'' C,,Ill tea"Fl�1-Fw,o C 1Y'�*�'i'erei ). arY�'.�$`z'yL F2 JF. f-"�'v+q'�-'^"wi*tT'sPJ"�`F� 3f"t f
<br /> -,-y^..�.r^.`, s"` .. ex Y'-�'iit.�_rs'e'.ti' F.+�ry�f:'��-y,r ... ,..:,:r ..,...,, ,rS ,r: n �r✓e+ .... .... .Ft.{ ., .b.: .�;`. t..,h.,..,,_�_ ._.yL....�.?f:X"e3e
<br /> Home ID number(if known): DMV X-plate number U./known):
<br /> PI Moving in from another state
<br /> Has no home ID or X-plate because: n Coming out of county deed records
<br /> ❑Other:
<br /> Manufacturer:Fleetwood I Model: Quartzville 28583R I Year:2022
<br /> • .. Manufacturer serial number. : HUD number '
<br /> •
<br /> FLE2100R22-22392A ORE 558593
<br /> FLE2100R22-223928 ORE 558594
<br /> *Number of sections: 2 I *Square footage: 1546 *Number of bedrooms: 3 *Number of bathrooms: 2
<br /> *Type of roofing: Arch. Comp.! *Type of siding: Vert. Cement *Heating: Electric *Cooling: None
<br /> *Date of sale: 04/11/2022 I *Sales price: 165,876.70 *Includes land: ❑Yes XNo
<br /> gI�#,�.�i�ztiau�t � �Y� I�-Z- i r n. Y r���}'` �.y��� ¢��-YYY,,,L;, ,+' y 1(rD�{.}c.i�'rj�5��>yrw"/�r'-s.c,e z �.yt Y{���j y��'>' �,w s ,��z�.., 1�S+ � ,..'�f
<br /> t.,R !+J "b +0.irr i.i rdri \gWi afraid rain refi���r.!fawn e._ F, x` r rk •'f.l '' t.. E
<br /> F_C)l.- �Kf/�,4;
<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 /> ■❑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
<br /> „' 1�f .)�'k"��;.1'✓'4�y-r,�'.7;F.'^��t " .rf�...fi5
<br /> signature:
<br /> 05/24/2022
<br /> Alta Cima Corp. I�n/ �
<br /> ;fvkf g � fiaYebiWi r i
<br /> r
<br /> _ ,eY,ei3kti r:rsysr. 5,, S ,X '0 Mviitswkit,.... 0alVz»ar "'_ ' . A: av z
<br /> .....:_
<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 />
|