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" NATLl.RI OF:�It,ING (eheck.,all"that applies) <br /> s c> er[JelGagest ❑ Change ownership e 'on o m 'ti <br /> or ' as p tl ty no i fr rea o tus 0 Trip permit ❑ v e orage <br /> Other:NEW HOME <br /> ,A PLICA►NT IN PORIt A1"IO f <br /> El Dealer/seller . ❑ 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:503-244-2300 <br /> Lmail:MELISA.COOK@CWRES.COM <br /> HOME INFORMATION'r required)' <br /> Home ID number(if known): DMV X-plate number(if known): <br /> TBD <br /> [l Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> n Other: <br /> Manufacturer:SKYLINE Model:WEST RIDGE Year:2023 <br /> Manufacturer serial number HUD number <br /> 245-000-H-A101479A ORE 560568 <br /> 245-000-H-A101479B ORE 560569 <br /> *Number of sections:2 *Square footage: 1344 *Number of bedrooms:2 *Number of bathrooms:2 <br /> *Type of roofing:COMP 1 *Type of siding:HARDIBOARD *Heating:HEAT PUMP *Cooling:HEAT PUMP <br /> *Date of sale:1-25-23 *Sales price:$145,735 *Includes land: ❑ Yes E No <br /> DEALER INFORMATION (If no de ley, White t� . <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> [1]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 /> roy TRANSPORTER.TRAP,PORTER4N,FORTATIPM (if not moving,leavq 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 />