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MANUFACTURER'S STATEMENT OR CERTIFICATE OF ORIGIN TO A MANUFACTURED HOME <br /> FIRST ASSIGNMENT <br /> MANUFACTURER:Fleetwood Homes For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> home described therein to: <br /> ADDRESS: 2655 Progress Way,Woodburn,OR 97071 . Address: • . <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> Street,City,State,and Zip the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> . Amt.Of Lien Date To Whom Due Address <br /> The undersigned MANUFACTURER hereby certifies that the new manufactured home described below, Dated at <br /> the property of said MANUFACTURER,has been transferred By: <br /> this 20th day of April 2023 on Invoice No 202372167500 Transferor(Fire,Name) Sign Here Position <br /> Dealer License(Permit)No. _ <br /> Before me personally appeared who by me being <br /> To: JO PROPERTY GROUP LLC duly sworn upon oath says that the statements set forth above are true and correct. <br /> Distributor,Dealer,Etc. Subscribed and sworn to before me this - day of , <br /> Notary Public for County,State of <br /> Whose Address is: 1700 ADAMS AVENUE SUITE 212 Notary Seal <br /> SECOND ASSIGNMENT <br /> Street <br /> For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> COSTA MESA,CA 92626 home described therein to: - — <br /> City.State,and Zip Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> Trade Name: 21 OS P-Sandpointe-14522A Model Year: 2023 the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Amt.Of Lien Date To Whom Due Address <br /> Model No: 210SP14522A Body Width Ft: _ 13'8" <br /> Body Length Ft: 56'0" /Ft: 52'0" Dated , at <br /> Including Hitch Excluding Hitch By: <br /> (F Transferor(Firm Name) Sign Here <br /> f %r Position <br /> Square Feet: 710 Date of Manufacture: 04/10/2023 _ Dealer License(Permit)No. <br /> Before me personally appeared who by me being <br /> Manufacturer's ID No: FLE2100R23-23224A Weight: 20,460 duly sworn upon oath says that the statements set forth above are true and correct. <br /> Subscribed and sworn to before me this day of , <br /> Manufacturer's ID No: Weight: Notary Public for County,State of <br /> Manufacturer's ID No: _ Weight: Notary Seal <br /> • <br /> THIRD ASSIGNMENT <br /> Manufacturer's ID No: Weight: • <br /> For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> Manufacturer's ID No: Weight: home described therein to: <br /> Manufacturer's ID No: Weight: Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> • The CORPORATION further Certifies that this was the first transfer of such new manufactured home in Amt.Of Lien Date To Whom Due Address <br /> ordinary trade and commerce. <br /> ,Fleetwood Homes Dated at <br /> By <br /> tpwntion Transferor(Firm Name) Sign Here <br /> l � Position • <br /> Dealer License(Permit)No. <br /> By: kA V ~`r Before me personally appeared who by me being <br /> Sign Name Title or Position duly sworn upon oath says that the statements set forth above are true and correct. <br /> 2655 Progress Way,Woodburn,OR 97071 Subscribed and sworn to before me this day of , <br /> Notary Public for County,State of <br /> Office Address of Signatgry(City&State) <br /> Notary Seal 1 <br />