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<br /> QI?=,FI O7NG=(cheep alf=th l I
<br /> • ❑ New home to MHODS X Adding or removing a co-owner • ❑ Demolition(Date:' • )
<br /> ❑ Used home sale ❑ Recording as real property El Converted to.storage, •
<br /> ❑ Security interest change ❑ Removing from real property status ❑ Trip Permit
<br /> El Transfer by
<br /> inheritance ❑ Other(please note):
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<br /> SECTIQW,�,,,f.,. .,.'�,r :���;!�.�.� ;,;.APPLIC�►IVT l l��(9RNIA;F'10 �pl pry t1. :•, .. k... d,,:�t,rt ;;
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<br /> Dealer/Seller ❑Lender ❑Escrow/Title Agent 'Owner/Buyer ❑Legal Representative .-. -
<br /> Name: Phone:� (?j Z•(first,middle,last) R �( � � /�'� ..-
<br /> Address: S SO 11 t MA I IJ set'. #--7 Q
<br /> City: Ku:Nor 1J DEL_ State:D�. ZIP: , ---/ 2:
<br /> Email:
<br /> rHOME
<br /> Home ID#: 23(tp aciir OR No Home ID: ❑New Home ❑Out of state home Leaving County.Deed Records.
<br /> Manufacturer: F L E-r—LAD 007)
<br /> .Model: U✓1 ty- oht7 v1 ... Year: 19 w0 ....
<br /> Serial Number(s) HUD Label Number(s)*Required if nevi, '' .....
<br /> D2F c_.. AA 32438 2`7 14 0R.E, Dgo 3i-13
<br /> #,•of Sections: 1. Sq.footage: CI 2 . Bedrooms: 2 Bathrooms: 2 •
<br /> Roofing type: m2'ta-1 . Siding type: V. L Q, Heating type: �tQ G- C _ Cooling type ;hat pUne.p
<br /> Date of sale: 5 J -1 l 5 Sale price: t' J f Includes land: Yes ri No t
<br /> (IjaPPlicable) Z / ❑
<br /> ..,SECTIO . :�`�".�°� .: .,�. �;:a-Y�� : .#, ��;i::����'. ; . •.. .....::., . t.. , ,':�.:::,.,{;x.;,,,:�:_. i�: ::>r,.�.<�:�.:;::•;. ;Name:
<br /> (first:middle;last) License#:.. .....
<br /> Address:' � -
<br /> ..
<br /> City: State:
<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 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 /> r+M;.4 � I�, v ^zY,sue._. �, .:.p� •,� � :: �'f a,s
<br /> Current Address: '3 O YIAAc UJ S-r, #co
<br /> ,City: JV.O>)TJ A l.)GE �fj l . County: MP O NI State:DR. Zip:Q 1736 2
<br /> Park Name:'(if applicable) >&UA- Att3 ❑This is a dealer lot or storage facility
<br /> ❑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: .
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