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• <br /> -it _ <br /> 13 opDQ5 � q7-731. <br /> NATUt i* +3 FlLINQ (cheek afi that`appliesj <br /> EcZ11 e s •°r t'nt est ❑Change ownership in ' 'on a d li 'o . <br /> di y e vin rom p e s s 'p r 1t ve t <br /> .❑■.Other:NEW HOME. <br /> APPLICANT INFOR tHATION <br /> Dealer/se.Ijer. ±`❑.Lender ❑ Escrow/title agent ❑ Owner/buyer , .❑ Legal.representative{, <br /> Name:COMMONWEALTH HOMEOWNER SERVICES <br /> Address(including city;State,and ZIP):18150 SW BOONES FERRY ROAD, PORTLAND, OR 97224 <br /> Phone:503-24k-2300 <br /> Email:MELISA:COOK@CWRES.COM . <br /> required): <br /> b � <br /> Home ID number(if known): DMV X-plate number(if known): <br /> TBD_. to b <br /> ❑ Moving in from another state <br /> :Has no home II/or X-plate because: (i Coming out of county deed records <br /> El Other: <br /> Manufacturer:SKYLINE Model:WEST RIDGE Year:2023 <br /> Manufacturer serial,number BUD number :,,,,.;_ , h;,.,,,: <br /> - ``" ' ''245-000-H-A101481A ORE 560572 <br /> r!, .:u .<; .245-000=H-A101481B ORE 560573 <br /> .*Number of sections:.2 *Square footage: 1344 *Number of bedrooms:2 , *Number of bathrboms:2 <br /> *Type of roofing:COMP *Type of siding:HARDIBOARD "'Heating:HEAT PUMP *Cooling:HEAT PUMP <br /> *Date of sale:1-25-23, *Sales price:$145,735 *Includes land: ❑ Yes ❑■ No <br /> DEALER INF ATI©N:(if no:dealer, Leave blank)- _ <br /> Dealer name: Dealer license number: Dealer address and phone: <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(print): Dealer signature: Date: <br /> t ANSPORTER If FORMATION (if:not mQving,"Ieave blank) <br /> Transporter name: Transporter address and phone: <br /> Newman's Mobile Home Transport PO Box 236 <br /> Silverton, OR 97381 <br /> 503-932-5142 <br /> 440-2952(7/17/COM) Page 2 <br />