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• 3. aq 3 4-i-Hi <br /> ...) <br /> UUUUJII,.II CIIVCIUr1C IU. ICUSCr'Yll-U4CU-4UOf-D4GU-Ul'UOr4:.7UCU cc <br /> f�IJ ` 0 V levy-N, <br /> • <br /> ..SEC.TI0N;1` r :.,. ;.; : ::.:.. •..,`..: .:. .: .•NATURE,'OF FILING.(check all that apRl9)•::`. '::-.. : . ` : : <br /> New home t MHODS • di ner [ t. ) <br /> ❑ U e sale - c as a t' r ve t - <br /> El ng e i r r .El Trip Permit <br /> ❑fir t se 0 Other(please note):New Home • . <br /> SECTION 2: APPLICANT;INFORMAlION:(iiifeaseprint) <br /> Q Dealer/Seller E Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative - <br /> Name:Furure Homes Albany • Phone:541=928-1555 • <br /> (first,middle, last) • <br /> • <br /> . Address:33964 Oakville rd. S.W. <br /> • , , City:Albany State:Or ZIP:97321 • • <br /> Email:nichol@futurehomesalbany.com <br /> •SECTION ': :.:; ,` :::•:,:.::;.•: ..:••,."HO.ME.INFORMATION.(information in bold is required) <br /> Home ID it: OR No Home ID: ❑I New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer:Fleetwood • (26•( S- <br /> ' <br /> Model:28523P • Year:2022 . <br /> Serial Number(s) - HUD Label Number(s) *Required if new home <br /> . FLE2100R2121554A ORE555586 _ <br /> FLE2100R2121554B - ORE555587 • - <br /> •#of Sections:•2 Sq,footage: 1333 Bedrooms: 3 Bathrooms: 2 <br /> Roofing type: ARCH Siding type: CEMENT Heating type: ELECTRIC Cooling type: NONE <br /> Date of sale:• 7/12/22 Sale price: 144554.00 Includes land: ❑Yes 0 No • <br /> • • Qfapplicable) <br /> . SECfiI0.N4: :,��:;.:.;-:1.::-;:>>.': ...::::':-�.'DtALERlNp.OR.MA7f0N::.(i.eave.=6lafik;af�no:dealer)`:.:: ::.::•.:°•.•:` '..` •�:::1:•::�.•.:- .••.":•; [..-: �- -:. <br /> • Name:Future Homes Albany LLC License#:MSD1068 .• , , <br /> (list,middle, last) <br /> Address:33964 oakville rd sw . . .. <br /> city:albany State:or zIP:97321 • . • <br /> • Email:nichol@futurehomesalbany.com Phone:5419281555 <br /> I hereby declare 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 or my interest in it. The information listed is true to the best of my knowledge and <br /> belief,and T understand it can be ed as evidence in court and is subject to a penalty of perjury. <br /> Signature: \it.'i(s2Ag, - Date: Alai a3 <br /> ECTaON:: ` :.,;.: :: ..,::> HOME LOCAT.ION: . • •• . . <br /> Current Address:33964 oakville rd sw <br /> city:albany . . County:linn . State:or zip:97321 <br /> Park Nanie: (if applicable) El This is a dealer lot or storage facility <br /> 0 This home is being moved to a new location Complete the section below <br /> New Address:2293 47th Ave.NE . <br /> city:Salem county:Marion State:OR Zip:97305 <br /> Park Name: (if applicable) ❑This is a dealer lot or storage facility <br /> Transporter Name:Same as dealer Phone: - ' <br /> Address: City: State: <br /> Email: . <br /> Page 2 - • <br />