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c <br /> Docusign Envelope ID:C79DC333-31 F8-4B3A-9410-07E5C50A5A37 <br /> 51 o ri L . ac-o 5 ; 1/1 <br /> `�S�CTION'1..,..:•.:-.:.:-.::_-:::,::::::-.�-�:_:�:::::::�:::�:;��_::.�::NAT.tARE;OFF1L#NG(check-allthat•aAP{Y}::��::�`:::: •:::� �'�: �_:.:�:•:�:-�.•-::_: . �.':-:-..•. <br /> New home to MHODS 15a/A it o r a e•owner <br /> Takjefeltgiaeksa e glacorithOurearNalaertY on i storage <br /> liOsc it9la z s.eltange 13--Ittem\ohinentrrieroperty status j Trip Permit <br /> [ eatctLearevitance ❑sOt a ea te): <br /> E1PPL�CANT::IINFORMATION le` n t ;::';:: <br /> .;:SECTION:2:�::::..::::::: =� ::�:�::� •::;;=.:.::::�::��:�.:� :;�...-.: .:....:. . ...- .... ..... ...( �s� n}:-. • <br /> • gDealer/Seller ❑Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name: <br /> (first,middle,last) Alta Cima Corp. Dba: Factory Expo Homes Phone:503-980-3990 <br /> Address: 2555 Progress Way <br /> City: Woodburn State:OR. z1P: 97071 <br /> Email:moconnell@factoryexpohomes.com <br /> Home ID#: kin/l_.1 OR No Home ID: XNew Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer: Fleetwood 4, I a�[, <br /> Model: Winnepeg 24443U Year: 2025 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> FLE2100R24-24272A <br /> FLE2100R24-24272B <br /> #ofSeetions: 2 Sq.footage: 1026 Bedrooms: 3 Bathrooms: 2 <br /> Roofing type: Arch Comp. Siding type: Lap Siding Heating type: Electric Cooling type: None <br /> Date of sale: rice: <br /> alapplicable) 08/07/2024 Sale P 94,118.00 Includes land: ❑Yes XNo <br /> :. _ .:..:..:......::.::_,:..:.::..::...:::-.:.:.::::.:::::.:::::::::;::.::;::::::;.D�LER=INFORMATION;.(leave:blanttjf nodeater).•`'�`::°:�;: �. :::.::�•:;'���::-:. :.:::�.-:�� <br /> Name: Alta Cima Corp. ba: FactoryExpo Homes License#: <br /> (first,middle,last) p• p MSD 448 <br /> Address: 2555 Progress Way <br /> City:Woodburn state: OR. zIP: 97071 <br /> • <br /> Email: moconnell@factoryexpohomes.com Phone: 503-980-3990 <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: Q"iehat2Ie Date: 09/18/2024 <br /> . . .-... .. .. .,..._ .��=:.:::::;::;.�;:;:::.;:;:�:.;.:.:�::::;:<��: HOME;LOCATION;;�.:::"c:::=:-:::-::�:;�'•::: ::.:.::..:. :.:,:..•. . <br /> - :...:...:. <br /> Current Address:2555 Progress Way <br /> City: Woodburn County: Marion State: OR Zip: 97071 <br /> Park Name:(if applicable) XThis is a dealer lot or storage facilit • <br /> y <br /> This home is being moved to a new location Complete the section below <br /> New Address: 5130 Briar Knob Loop <br /> City:Scotts Mills County:Marion State: OR Zip: 97375 <br /> Park Name:(ifapplicable) ❑This is a dealer lot or storage facility <br /> Transporter Name: Customer providing own freight Phone: <br /> Address: City: State: <br /> Email: <br /> Page 2 <br />