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Authentisign ID 54BC24DA-EA52-F011-8F7C-000D3A8A9962 0 /T <br /> CCCJTTT� V L(.�.r i/1�Lra,S4,_r DR SE I bCXo. SG,le.crn 9 .73 <br /> SECTION 1 "�" NATURE OF FILING (check all that apply) <br /> ❑� New home to MHODS • er <br /> 174 s'ftb rty d te- t�C l'age. <br /> VYio a tviatnge e i r p e atus ❑l Trip Permit <br /> > ce Kl` Otl i e note): <br /> SECTION 2e • �;. `" . � APPLICANT INFORMATION (please-print) • <br /> ❑■ Dealer/Seller ❑Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑-Legal Representative <br /> Name:COMMONWEALTH HOMEOWNER SERVICES,INC. Phone: - <br /> (first, middle,last).• <br /> Address:18150 SW BOONES FERRY RD <br /> City:PORTLAND State:OR ZIP:97224 <br /> Email:MELISA.COOK@CW RES.COM <br /> SECTION 3 HOME INFORMATION.(information;in bold is required),„,.r ; <br /> Home ID#: E OR No Home ID: ❑■ New Home ❑Out of state home.❑Leaving County Deed Records <br /> Manufacturer:CAVCO MANUFACTURING,LLC:CAVCO WOODBURN . ( O7 3& O <br /> Model:210SP28482A Year:2025 <br /> Serial Number(s) HUD Label Number(s) *Required if new home <br /> FLE2100R25-24654A ORE 567176 <br /> FLE2100R25-24654E ORE 567177 <br /> #of Sections: 2 Sq.footage: 1333 Bedrooms: 2 Bathrooms: 2 <br /> Roofing type:-COMP Siding type: LAP CEMENT Heating type: ELECTRIC .Cooling type:::NONE•' <br /> Date of sale: 4-18-25 Sale price: $109,541 Includes land: ❑Yes ■❑No <br /> - - gapplicable) <br /> SECTION 4 DEALER.INFORMATION(leave blank f no dealer) . < " <br /> Name: License#: <br /> (first,middle, last) <br /> Address: <br /> City: State: ZIP: . <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: Date: <br /> ,SECTION 5 !HOME,LOCATION • <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 /> El This home is being moved to a new location Complete the section below <br /> New Address:2410 Lancaster Dr SE SP.#1006 <br /> City:SALEM County:MARION State:OR Zip:97317 <br /> Park Name: (if applicable) SUNDIAL MHP ❑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 />