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- ' MAN T UFACT RER'S STATEMENT OR CERTIFICATE-OF ORIGIN TO A MANUFACTURED HOME _ .__._ • ' FIRST ASSIGNMENT . . . and the manufactured MANUFACTURER: Fleetwood Homes,Inc. u -T3r7' For Value Received,the undeC tl h y s tatement o non !lw home described therein to: 4-[ __- _:.:.'; •..'Address:�7.f91� L¢t.+rtiCasi lac I t/�' b r Y ADDRESS: 2655 PfOgfeSS'Way,:W oodbum,OR 97071 •-• : and certifies that the home is new and has not been registered in this or any other state;he also warrants Street.City.State.and Zip • - -the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below . Amt.Of Lien Date To Whom Due' Address The undersigned MANUFACTURER hereby certifies that the new manufactured home described below, Dated at T�4.'kn Of the property of said MANUFACTURER,has been transferred cr>b01. By: ` Here Position this 20th day of February , 2023 on Invoice No 202268180900 Dealer Lic - No. O � Before me 7p v`-' who by me being To: FACTORY HOMES CLEARANCE CENTER duly sworn ys t ni, 1 e e d correct. Distributor,Dealer.Etc Subscribed to be �tl it�f�� v ��-j3� MY COMMIS$1�4 Rr$�� County,State of C'_ ..6 Whose Address is: PO BOX 2176 Notary Seal SECOND ASSIGNMENT Street For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured TUALATIN,OR 97062 home described therein to: City.State.andAddress: Zip and certifies that the home is new and has not been registered in this or any other state;he also warrants Trade Name: 210SP-Sandpointe-14441A Model Year: 2023 the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below Amt Of Lien Date To Whom Due Address Model No: 210SP144-I1A Body Width Ft 13'8" Body Length Ft: _ 48'0" /Ft 44'0" Dated , B,at Including Hitch Ercltrding Hitch Transferor(Firm Name) Sign Here Position Square Feet: 601 Date of Manufacture: 02/17/2023 Dealer License(Permit)No. Before me personally appeared who by me being duly sworn upon oath says that the statements set forth above are true and correct. Manufacturer's ID No: FLE2100R23-23097A Weight 18.540 Subscribed and sworn to before me this day of Manufacturer's ID No: Weight: Notary Public for County,State of Manufacturer's ID No: Weight Notary Seal THIRD ASSIGNMENT Manufacturer's ID No: Weight: For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured • Manufacturer's ID No: Weight: home described therein to: Manufacturer's ID No: Weight Address: and certifies that the home is new and has not been registered in this or any other state;he also warrants the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below The CORPORATION further Certifies that this was the first transfer of such new manufactured home in Amt Of Lien Date To Whom Due • Address ordinary trade and commerce. Fleetwood Homes,Inc. _ Dated at BY Corporation • Transferor(Fran Name) Sign Here . Position • Dealer License(Permit)No.. BY ,,• r.1� ..SS 5� =� Before me personally appeared who by me being ign Name line or Position duly sworn upon oath says that the statements set forth above are true and correct. .. 2655 Progress Way,Woodbum,OR 97071 Subscribed and sworn to before me this day of , ' Notary Public for County,State of - Office Address of Signatory(City&State) Notary Seal