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Q-D.406 _ciLnca &ley DR . •7 3/ <br /> NATURE OF FILING (check all that applies) <br /> ge s ur in t ❑ Change ownership e o ' 'on f e• o r <br /> cor ' g ea g r n pr ty s f ' er er Te <br /> 0 Other:NEW HOME <br /> APPLICANT INFORMATION <br /> 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 /> Email:MELISA.COOK@CWRES.COM <br /> :HOMEINFORMATION (* required) , , <br /> Home ID number(if known): DMV X-plate number(if known): <br /> TBD . C> Crl� <br /> Moving in from another state <br /> Has no home ID or X-plate because: L Coming out of county deed records <br /> 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 bathroorns: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 D No <br /> "."DEAL-ER <br /> a <br /> DEALER INFORMATION;(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 /> , <br /> k'` TRANSPORTER INFORMATION (if not inoving, leave 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 />