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e-rnci,_lecd #0 ,otroi , haSalI Cn m 9 )-4 <br /> " � dig�• `�- <br /> SECTION,1 �_ = [ A �JO�rF11iNG�� eEk altt6atpplyl 4 <br /> ❑ New home to MHODS ❑ Adding or removing a co-owner ❑ Demolition(Date: ) <br /> ❑■ Used home sale ❑ Recording as real property ❑ Converted to storage <br /> ❑ Security interest change D Removing from real property status ❑ Trip Permit <br /> ❑ Transfer by inheritance ❑ Other(please note): <br /> > aC ION 2 �i t� h � r v _r AP 1C.}�N SORMAT�t©O �s gmt3 : ., ,_ . Et I xz,2m b <br /> rt, �, � _..-t ,� P .__ .� - .. �� � t .� ,�� .�'�� � ate. =� <br /> ❑Dealer/Seller ❑Lender El Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name y <br /> Fidelit National Title Phone: 503-585-7219 <br /> Urst,mid ,last)dle <br /> Address: 500 Liberty St Se, Ste 200 <br /> City: Salem State: OR ZIP: 97301 <br /> Email: Christine.Brinton@fnf.com <br /> O::*tfl ' - tz Z.k.: .P ri1OME 1NFORMATJ p rf(tnformatiort ttiybofid Riii reds' to( (,(. - .iYal?..J :j.s <br /> Home ID#: 204267 OR No Home ID: ❑New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer: Ridgewood <br /> Model: Unknown Year: 1976 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> LO9R10040 <br /> #of Sections: 1 Sq.footage: 784 Bedrooms: 2 Bathrooms: 1 <br /> Roofing type: Metal Siding type: Vinyl Heating type: Electric Cooling type: Air Conditioner <br /> Date of sale: 8'l /2025 Sale price: $62,500.00 Includes land: ElYes ❑■ No <br /> f applicable) <br /> ieGTianl` L P DEALER il!IFORM TreO leay.� iiak o tl igxk 1, '� �r; '=y <br /> Name: <br /> (first,middle,last) License#: <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 /> �� '. '� rp 1,�rl�, ��`� —�`� c �Fl.-='�i`. �i'�s f"�",�y-'� ' k s y 7 �^ �+��. r <br /> `1 .7 S N sni.:_.3s aggro H ► d O TI '��a. -1 iM -. .! '£I,f r ty <br /> n,a ,., s,.� sr :.=��k� �..�kti�-...�C �-:� � �.. ��n �,5�t`�!�? .,, rg .�'.�<G�.-..��i�,,,��.�'� _ata.ar�". ,a���.'�a.:�"��a��k,C'.��" <br /> Current Address: 340 NE Crest St, Spc 74 <br /> city: Sublimity county: Marion State: OR Zip: 97385 <br /> Park Name: (ifapplicable) Sublimity Mobile Village ❑This is a dealer lot or storage facility <br /> 0 This home is being moved to a new location Complete the section below <br /> New Address: <br /> City: County: State: Zip: <br /> Park Name: (if applicable) ❑This is a dealer lot or storage facility <br /> Transporter Name: Phone: <br /> Address: City: State: <br /> Email: <br /> Page 2 <br />