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<br /> Dealer/seller ❑ Lender ❑ Escrow/title agent ❑ Owner/buyer ❑ 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
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<br /> Home ID number(if known): DMV X-plate number(if known):
<br /> ❑Moving in from another state
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<br /> Has no home ID or X-plate because: n Coming out of county deed records - '
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<br /> ❑Other:
<br /> Manufacturer:Fleetwood Model: Redding 28483T Year: 2023
<br /> Manufacturer serial number' ' HUD number
<br /> FLE2100R22-23001A 300 i p c n'1cirj ecQ`"or5t Fa"
<br /> ,,......FLE2100R22-23081-B- 0.3 to 5 . . .:.._ .._:_e.,
<br /> *Number of sections: 2 *Square footage: 1280 *Number of bedrooms:3 *Number of bathrooms; 2
<br /> *Type ofroofing:Arch Comp. *Type of siding: Vert. Cement *Heating: Electric *Cooling: None.-..
<br /> *Date of sale: 04/20/2022 . *Sales price: 148,751.37 *Includes land: ❑ Yes N(No
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<br /> Dealer name: Dealer license number: Dealer address and phone:
<br /> Alta Cirna Corp. MSD 448 2555 Progress Way
<br /> Dba: Factory Expo Homes Woodburn, OR. 97071 ' '
<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 6)1-int): Dealer signature: Date:
<br /> Alta Cima Corp, 711440, h-it 12/05/2022
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<br /> Transporter name: Transporter address and phone:
<br /> Superior Home Transport, LLC PO Box 1067
<br /> Jefferson, OR, 97352
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<br /> 440-2952(7/19/COM) Page 2 .
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