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1539023 AI <br /> :SCOT `i te . .` ._a <tTRE�®EFI <br /> ., ULING <br /> S <br /> i seaL o s e �gl e <br /> t e o r s eTrip Permit <br /> e ea <br /> Si1G`�10 - <br /> ..,- .s-�N'�. . ,. . ,�< �s � . � �y Pi�I±��QNT 1➢Vf OR� TI�N�fP�l�s��Pn•9t�_ ;: .�� � : .• '.1',. .c.. _ <br /> n Dealer/Seller r Lender r Escrow/Title Agent n Owner/Buyer r Legal Representative <br /> Name: Bert Munger and Melody Munger <br /> (first,middle,last) Phone: <br /> Address: 35846 NIAGARA HEIGHTS RD <br /> City: MILL CITY State: OR ZIP: <br /> 97346 <br /> Email: <br /> x'SEGTJO15.3 i, ,m.. ,•n HONfE10100M/TION4Infomation:inbotdisre cared ,' i, <br /> Home ID#: OR No Home ID:C New Home I:Out of state home 0 Leaving County Deed Records ry <br /> Manufacturer: CLAYTON &C7 B S&6 (54 D O C4 l) <br /> Model: DRM482P Year: 2023 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> ALB042933ORAB <br /> #of Sections: 2 Sq.footage: et(00 : Bedrooms: t Bathrooms: "Z_ <br /> Roofing type: Siding type:3,1\Aktzt 412.46, Heating type: Ecze ,c. Cooling type:e-t i jt e. <br /> Date of sale y <br /> (Ifapplleab/e) LU/ j''Z3 Sale price: tiviA-34..t Includes land: r Yes TNo <br /> E;SECTION;4 . �'_ °" : DEALER INFORMATION'(�eave•li1ank lf,no deaier) ", <br /> Name: CLAYTON HOMES ALBANY,OR Laced R #MS D 195 <br /> (first,middle,last) <br /> CCB #1116990 <br /> Address: 1437 CENTURY DRIVE NE <br /> City: ALBANY State: OR ZIP: 97322 <br /> Email: Phone: (541)967-8555 <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: Y ( <br /> t .A(1 P Date: 101\ 12 <br /> 'SECTIONS, r <br /> - - ' �` HOME LOCATION <br /> — Current Address: z.3.414 j syf Pilo piG 81,,v0 <br /> City: Act-S l+cr rLj County: U IV nJ State: Cle Zip: 441 L I <br /> Park Name:(if applicable) r This is a dealer lot or storage facility <br /> r This home is being moved to a new location Complete the section below <br /> • New Address:rs C,9 y-G N t ei elk!, <br /> City:' ( ATES County: -fteoasIM41,-;orl State: C1 Zip: Ci I.71-6, <br /> Park Name:0/applicable) r This is a dealer lot or storage facility <br /> Transporter Name: FBI t1eT-r 'rg.txt=4t\((-) Phone: <br /> Address:e,J gO' taw 0 S City:lkA G 1) V61 A- State: 6,4- <br /> Email: <br /> 440-2952(11/22BCD) Page 2 <br /> OR Title Application-7/2023-TitleApp 1121 I 004808919-00002 <br />