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❑Chan Serest ❑ £.'.......',.ti'.;,'.. <br /> Trl� `eev�D�[i��. <br /> El-ROSer-diftg-frrreatillUptsrty MIL _ - •. : .-- . . -s ❑� Trip permit n^- _a. e <br /> Ot <br /> APPLICANT INFORMATION <br /> 0 Dealer/seller ❑ Lender ❑Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name:Commonwealth Homeowner Services <br /> Address(including city,state,and ZIP):18150 SW Boones Ferry Road, Portland, OR 97224 <br /> Phone:503-244-2300 <br /> Email:melisa.cook@cwres.com <br /> :HOME=INFPRMAILP!.t(!6 required) <br /> Home ID number(if known): DMV X-plate number(if known): <br /> TBD N vJ A354 —1-54 <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> ❑Other: <br /> Manufacturer:SKYLINE Model:RAMADA Year:2018 <br /> Manufacturer serial number HUD number <br /> KQ-91-0357-K-B <br /> KQ-91-0357-K-A <br /> *Number of sections:2 *Square footage: 1344 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofing:COMP *Type of siding:T1-11 *Heating:ELECTRIC *Cooling:NONE <br /> *Date of sale:2-15-18 *Sales price:$63,746 *Includes land: ❑ Yes 0 No <br /> DEALER INFORMATION (if no rdealer,t leave blank) r <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> COMMONWEALTH HOMEOWNER MSD 508 18150 SW BOONES FERRY ROAD <br /> SERVICES, INC. PORTLAND, OR 97224 <br /> ❑� 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. <br /> I hereby declare that the above statement is true to the best of my knowledge and belief,and that I understand it is <br /> made for use as evidence in court and is subject to penalty for perjury. <br /> Dealer name(print): Dealer signature: Date: <br /> COMMONWEALTH-CHS <br /> TRANSPORTER INFORMATION (if notmoving, leave blank) <br /> Transporter name: Transporter address and phone: <br /> THEROUX NORTHWEST PO BOX 1287 ,70,---)E-TIED`� , DD <br /> - <br /> OREGON CITY, OR 97045 ^?3-05 1 .._ <br /> t) <br /> 503-655-5626 <br /> 440-2952(7/17/COM) Page 2 <br />