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MANUFACTURER'S STATEMENT OR CERTIFICATE OF ORIGIN TO A MANUFACTURED HOME
<br /> •
<br /> FIRST ASSIGNMENT
<br /> Manufacturer: Cavco Manufacturing, LLC :Cavco Millersburg •For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured
<br /> home described therein to: `j o.C.l.;:-'3. \C
<br /> Address: 3737 Palm Harbor Drive,Millersburg,OR 97321
<br /> Address AS 1 C;3 S�,.-, ( ..-,—,c`a.,-, ;-+z..c'r._i Q..,,� c;',:v" a \. "R.— ""0,t4 WA
<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 7 /�
<br /> the property of said MANUFACTURER,has been transferred ' !.'
<br /> l r-v,:rcx v-ec 4t`8- �,. ar .BY: ( 0 .c;
<br /> This 25th day of April , 2025 on Invoice 2025093196600 Transferor(Firm Name) ,/�iqn Here As/lion
<br /> Dealer License(Permit)No. a`\r"‘' •SJ Ca.., ✓
<br /> Before me personally appeared C:V.cti s. (. ;-. -) 4, who by me being
<br /> To: COMMONWEALTH HOMEOWNER SERVICES, INC. • duly sworn upon oath says that the statements set forth above are t?ue and correct.
<br /> Distributor,Dealer,Etc. ;�..), Subscre nkysya before me this VA day of CV` �- — , 1-D�..`a'
<br /> MF_LISA eoo Notary Public fora,),,,,,N,,, .:.1-.,,-., County,State of 1M ,.c -,,
<br /> ‘,..--) NOTAWid?JBl,JC-OREGON vWhose Address 18150 SW BOONES FERRY ROADCOMMISSION NO.1014450 SECOND ASSIGNMENT
<br /> Street MY CO"I W-WPRIMNItYMnagge5ant d hereby transfers this Statement of Origin and the manufactured
<br /> PORTLAND,OR 97224 • 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 /> the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below
<br /> 2025
<br /> Series: Paradise Model Year: 1
<br /> Amt.Of Lien Date To Whom Due Address
<br /> Model No: 310PL15401A Body Width Ft: 14'8" _.
<br /> Body Length Ft: 61'4" /Ft: 57'4" Dated , at
<br /> Including Hitch Excluding Hitch By.
<br /> Transferor(Firm Name) Sign Here Position
<br /> ' Square Feet: 753 Date of Manufacture: 04/24/2025 Dealer License(Permit)No.
<br /> Before me personally appeared who by me being
<br /> duly sworn upon oath says that the statements set forth above are true and correct.
<br /> Manufacturer's ID No: PHH3100R25-16389A- Weight 26,100 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 • NotarySeal
<br /> THIRD ASSIGNMENT.
<br /> Manufacturer's ID No: Weight 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 /> Cavco Manufactur�g[LLC:Cav hi' ersburg gated at
<br /> By:
<br /> rpnration •
<br /> Transferor(Firm Name) Sign Here • Position
<br /> Dealer License(Permit)No. •
<br /> By: t C -- Before me personally appeared who by me being
<br /> Sign Name Title or Position duly sworn uponoath says that the statements set forth above are true and correct.
<br /> Y
<br /> • 3737 Palm Harbor Drive,Millersburg, OR 97321 Subscribed and sworn to before me this day of ,
<br /> Notary Public for - County,State of .
<br /> Office Address of Signatory(City&State)
<br /> Notary Seal
<br />
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