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606729
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Last modified
5/2/2023 1:00:11 PM
Creation date
3/9/2023 7:49:46 AM
Metadata
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Template:
Assessor
Account Number
606729
Assessor Doc Type
Field Sheet/Notes
Tax Year
2023-24
Doc Type Date
3/8/2023
MTL
072W06BA00800
Assessor Section
Manufactured Structures
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N uIANUFACT RER'S STATEMENT OR CERTIFICATE OF ORIGIN TO A MANUFACTURED HOME <br /> FIRST ASSIGNMENT . <br /> For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> MANUFACTURER. Fleetwood Homes,Inc. home described therein to: <br /> Address: in this or anyother state;he also warrants <br /> ADDRESS: 2655 Progress Way,Woodburn,OR 97071 and certifies that the home is new and has not been registered <br /> Street,City,Stale,and Zip the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Amt.Of Lieu Date To Whom Due Address <br /> • <br /> Dated The undersigned MANUFACTURER hereby certifies that the new manufactured home described below, D atBY <br /> the Property of said MANUFACTURER,has been transferred Transferor(Finn Name) Sim Here Position <br /> 2022 on Invoice No 202160030200 Dealer License(Permit)No. who by me being <br /> 1st day of November Before me personally appeared <br /> duly sworn upon oath says that the statements set forth above are true and correct. <br /> To: JO PROPERTY GROUP LLC Subscribed and sworn to before me this day of county,State of <br /> Distributor,Deal Etc. Nosy Public for <br /> Notary Seal <br /> Whose Address is: 1700 ADAMS AVENUE SUITE 212 SECOND ASSIGNMENT <br /> Street For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> . home described therein to: <br /> COSTA MESA CA 92826 Address: <br /> City,State,and Zip and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> Trade Name: 210SP-Sar►dDo ►te-14522A Model Year: <br /> 2023 the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Amt.Of Lien Date To Whom Due Address <br /> Width Ft: 13'8" <br /> Model No: 210SP14522A Body atBody Length Ft: 56'0" /Ft: 52'0' Dated ' BY <br /> Including Nude <br /> Excluding Hitch 71nnsferar(Firm Name) Sign Here Position <br /> Square Feet 710 <br /> Date of Manufacture: 10/21/2022 Dealer License(Permit)No. <br /> Before me personally appearedwho by me being <br /> duty sworn upon oath says that the statements set forth above arc true and correct. <br /> Weight: 24,130 Subscribed and sworn to before me this day of <br /> Manufacturer's ID No: FLE2100R22-22810A Notary Public for County,State of <br /> Manufacturer's ID No: Weight: <br /> Notary Seal <br /> Manufacturer's ID No: - <br /> Weight: THIRD ASSIGNMENT <br /> Manufacturer's ID No: Weight: For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> Weight: home described therein to: <br /> Manufacturer's ID No: Address: <br /> Manufacturer's ID No: Weight: and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> The CORPORATION further Certifies that this was the first transfer of such new manufactured home in Amt.Of Lien Date <br /> To Whom Due Address <br /> ordinary trade and commerce_ <br /> DatedFleetwood Hanes,Inc. <br /> Transferor(Firm Name) Sign Here Pasirton <br /> Corporwiott <br /> Dealer License(Permit)No. <br /> • <br /> By: - In CGS /rq n y �'� Before me personally appeared who by me being <br /> Smo Nmee Title Position duly sworn upon oath says that the statements set forth above are true and correct <br /> Subscribed and sworn to before me this dam`of County,State of ' <br /> 2655progress Way,Woodburn,OR-97071 Notary Public for <br /> • Office A ldrrss of Signatory(City it State). Notary Seal . <br />
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