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<br /> MANUFACTURERS STATEMENT OR CERTIFICATE OF ORIGIN T®.A MANUFACTURED HOME •
<br /> FIRST ASSIGNMENT
<br /> MANUFACTURER:Cavco Manufacturing, LLC:Cavco Woodburn • • For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured
<br /> home described therein to: (';(''_L, ��._,_.,-,�.)� 6.};„•N,,+— 'LA eC
<br /> ADDRESS: 2655 Progress Way,Woodbum,OR 97071 Address: \�,.'\'c, S-� ti, r,r.r P A tA-,--?a�,.ta. �2--y��. \.•t
<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 deliver
<br /> y,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 f) ,,?..:
<br /> the property of said MANUFACTURER,has been transferred
<br /> fir--`......0,0" rk.k..,.,, $S j -tr
<br /> this 18th day of April , 2025 on Invoice No 202592760500 Transferor(Firm Name) j S.17 Here Po Lion
<br /> Dealer License(Permit)No. v'\r\St)S'Ogi
<br /> Before me personally appeared Cs Q,..,,-mac( L'i<n y 'as1,: -- who by me being
<br /> To: COMMONWEALTH HOMEOWNER SERVICES,INC. duty e„„,r^"rn path says*ha*thr itements set forth above are true`5ltd correct.
<br /> SubscribOF6i6lAli TAM fore me ' NA day of (Z-,tk„r� , - , c�Q-S—
<br /> Dstributor,Dealer,Etc.
<br /> �� MEUSA COOPQNIotary Pu is for \A��,,-,\r•�.,- c;...�,,,u County,State of v[v �.�
<br /> eV:; NOT, I,ILIC-OHEGON
<br /> Whose Address is: 18150 SW BOONES FERRY ROAD COMMISSION NO.1014450 SECOND ASSIGNMENT
<br /> Street MY C(I A1SPN1 EPIRES JULY 08 2025
<br /> •
<br /> or o tie eocsrtxi,tL a.r lc,�,b. ereby 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 /> Trade Name: 210SP-Sandpointe-28482A Model Year: 2025 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: 210SP28482A Body Width Ft: 26'8" —
<br /> Body Length Ft: 62'0" /Ft: 58'0" Dated , at
<br /> Including Hitch Excluding Hitch By
<br /> Transferor(Firm Name) Sign Here Position
<br /> Square Feet: 1333 Date of Manufacture: 04/17/2025 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: FLE2100R25-24654A Weight:_ 20,400 Subscribed and sworn to before me this day of
<br /> Manufacturer's ID No: FLE210OR25-24654E Weight: '23,250 : • - Notary Public for County,State of •
<br /> Manufacturer's ID No: Weight: Notary Seal
<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 registeral 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 Manufacturing,LLC: vc Woodbum Dated, , at
<br /> •
<br /> . By:
<br /> Corporation •
<br /> ACC-4
<br /> � Transferor(Firm Name) Sign Here Position
<br /> ® By: I:c ('#C f.E ,p A47 5Dealer License(Permit)No.
<br /> --Before me personally appeared who by me being
<br /> Sign Name t e or Position duly sworn upon oath says that the statements set forth above are true and correct.
<br /> 2655 Progress Way,Woodbum,OR 97071 •. 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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