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i-a-ncastc/ Dr Se o. 8 ) <br /> EECTlON'1 ., y NATURE;OF FILING'(ciheckall that apply) ; <br /> E New home to MHODS i in - r tttitiTN(Date:_ ) <br /> 1 lii tl fins K11.012vitere11,46%at�Ai ge <br /> e e a r us I Trip Permit <br /> gf8ifilwrl'tface lfek(l71ek,seThigei): <br /> h ECTI( N - ,::AP,PfACAOT INFO`RMATION.(please print) <br /> 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:97224 <br /> Email:MELISA.COOK@CWRES.COM <br /> HOME;INFORMATION°(lnforratioti In bold is"required). ; • <br /> ...°s <br /> Home ID#: E OR No Home ID: Q New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer:FLEETWOOD (6 (�q 7,v <br /> Model:210EV28502E Year:2024 <br /> ' Serial Number(s) HUD Label Number(s)*Required if new home <br /> FLE2100R23-23656A ORE 562796 <br /> FLE2100R23-236564 ORE 562797 <br /> #of Sections: 2 Sq.footage: 1333 Bedrooms: 3 Bathrooms: 2 <br /> Roofing type: COMP Siding type: Vertical Small Heating type: ELECTRIC Cooling type: NONE <br /> Date of sale: Sale price: $119,744 Includes land: ❑Yes ❑® No <br /> (fapplicable) 1 a t 3 ?.3 <br /> kECT10N 4 '` :`DEALER,CNFORMATION(leave'blank;if no dearer) < <br /> Name:COMMONWEALTH HOMEOWNER SERVICES, INC. License#:MSD508 <br /> (first,middle,last) <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: sc\_ , Date: � t� <br /> °`HOME!;' CATIO1 <br /> Current Address:2655 PROGRESS WAY <br /> City:WOODBURN County:MARION State:OR Zip:97071 <br /> Park Name: (if applicable) ❑This is a dealer lot or storage facility <br /> 0 This home is being moved to a new location Complete the section below <br /> New Address:2200 LANCASTER DRIVE SE, SR #28 <br /> City:SALEM County:MARION State:OR Zip:97317 <br /> Park Name: (if applicable) SUNDIAL MHC 0 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 />