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... . 3 aq 3 <br /> -1--i'llhc N) (E- <br /> ) . <br /> V euoIUII CIIVCIUpe IV. ICUvcrtAt-UYCU-YVOt-DYLU-JI,UOr YUUCU IJ �/ 3 / j <br /> SECTION: NATURE OF FILING (check:all that;apply) :::. :: <br /> U New home t MHODS di e • t, - Trier n ' r t te: <br /> ❑ U e sale c as a r r vse-tt stto a <br /> ❑ ng e ii i • r ❑■ Trip Permit <br /> ❑ it 0 Other(please note):New Home <br /> SECTION..2-.: : 'APPLICANT INFORMATION (please:print) <br /> 111 Dealer/Seller ❑Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name:Furure Homes AlbanyPhone:541-928=1555 <br /> (first, middle, last) <br /> Address:33964 Oakville rd. S.W. <br /> city:Albany State:Or ZIP:97321 • <br /> Email:nichol@futurehomesalbany.com <br /> SECTION:3 HOME INFORMATION (information in bold is required) ; <br /> Home-Ib it: . OR No Home ID: Q New Home D Out of state home ❑Leaving County Deed Records <br /> Manufacturer:Fleetwood <br /> Mode1:28523P 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 No <br /> afapplicable) <br /> SECTION 4 : , 'DEALERt',INFORMATION (leav:e.blank-if no dealer) <br /> Name:•Future Homes Alban LLC <br /> License#:MSD1068 <br /> (Just, middle, last y <br /> Address:33964 oakville rd sw <br /> City:albany State:or ZIP:97321 <br /> Email:nichol@futurehomesalbany.com Phone:5419281555 <br /> I hereby declare <br /> r this manufactured structure is free and clear of all mortgages, security es, deeds of trust, 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 I urn nderstand it can be cd_as evidence in court and is subject to a penalty of perjury. <br /> Signature: \)\ .,\ 1 Date: <br /> : ECTION::S _. . .: : 'HOME:LOCATION , <br /> current Address:33964 oakville rd sw <br /> City:albany . County:linn State:or Zip:97321 <br /> Park Name: (if applicable) 0 This is a dealer lot or storage facility <br /> ❑� 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: Of applicable) ❑This is a dealer lot or storage facility <br /> Transporter Name:Same as dealer Phone: <br /> Address: Y <br /> Cit r State: <br /> Email: . <br /> I <br /> Page 2 <br />