Laserfiche WebLink
d t__anca_G-1- )7 -OR SE 49A S 9 -131 -7 <br /> SECTION 1 ` NATURE OF FILING(check all that apply): <br /> Ej New home to MHODS SZVAAIdfie 401.4geS-NeWher [Q]iDaplita(inte: ) <br /> se m r • 'IS-112 erte o st age <br /> e ange m fr pro s tus • Trip Permit <br /> ns y i ce e e note): <br /> SECTION 2 = APPLICANT INFORMATION(please print) <br /> 0 Dealer/Seller ❑Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name:COMMONWEALTH HOMEOWNER SERVICES Phone:503-244-2300 <br /> (/first, middle,last) <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97227 <br /> Email:MELISA.COOK@CWRES.COM <br /> SECTION 3 HOME INFORMATION(information In bold is required) <br /> Home ID#: I v Vv OR No Home ID: ❑� New Home ❑Out of state home El Leaving County Deed Records <br /> Manufacturer:CLAYTON (.00-1d-37 <br /> Model:72DRM14482 AH23 Year:2023 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> ALB042572OR NTA 2176623 <br /> #of Sections: 1 Sq.footage: 648 Bedrooms: 2 Bathrooms: 1 <br /> Roofing type: COMP Siding type: Vertical Cemb Heating type: ELECTRIC Cooling type: NONE <br /> Date of sale: 6-1-23 Sale price: $52,664 Includes land: ❑Yes 1:j No <br /> afappltcable) <br /> SECTION 4 . DEALER INFORMATION(leave blank if no dealer) <br /> Name:(first,middle,last)COMMONWEALTH HOMEOWNER SERVICES, INC. License#:MSD508 <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97224 <br /> Email: Phone: <br /> I hereby declare 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 or my interest in it. The information listed is true to the best of my knowledge and <br /> belief,and I understand it can be used as evidence in court and is subject to a penalty of perjury. <br /> Signature: '\'`,.._k.s � Date: I1 <br /> SECTION 5 , .HOME LOCATION <br /> Current Address:2445 PACIFIC BLVD SW <br /> City:ALBANY County:LINN State:OR Zip:97321 <br /> Park Name:(if applicable) 0 This is a dealer lot or storage facility <br /> This home is being moved to a new location Complete the section below <br /> New Address:2200 LANCASTER DRIVE SE, SP.#9A <br /> City:SALEM County:MARION State:OR Zip:97317 <br /> Park Name: (if applicable) SUNDIAL MHP ❑This is a dealer lot or storage facility <br /> Transporter Name:NEWMAN'S MOBILE HOME TRANSPORT Phone: 503-932-5142 <br /> Address:PO BOX 236 City: SILVERTON State: OR <br /> Email: <br /> Page 2 <br />