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• <br /> .r ' x , xt s NATURE O'FILING (check all'tiia yap • <br /> ■-= - • ❑d ip ❑- emalitioo E4ttc of demolition: <br /> ❑ - , ' :.• . ••- - atus Q Trip permit ❑ <br /> Cl Dealer/seller ❑Lender ❑Escrow/title agent ❑ Owner/buyer ❑Legal representative <br /> Name:HOMES DIRECT OF OREGON <br /> Address(including city, state, and ZIP):3838 PALM HARBOR DR NE, MILLERSBURG, OR 97321 <br /> Phone;541-928-2083 <br /> Email:neilaw31@gmail.com <br /> �t; aHbME�;INFORMATION�(*'required), �x �'`� N r <br /> I-Iome ID number(if known): DMV X-plate number(if known): <br /> 374774 (LOIS) 1('1 3 5 5 3 B 5 <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> Q Other:NEW HOME <br /> Manufacturer:PALM HARBOR HOMES Model:310HD30683A Year:2014 <br /> Manufacturer serial number HUD number <br /> PH H310 R 13-11018A O R E522970 <br /> PHH3100R13-110186 ORE522971 <br /> • <br /> *Number of sections:2 *Square footage: 1963 *Number of bedrooms:3 *Number of bathroonms:2 <br /> *Type of roofing:COMP. *Type of siding:VERT. CEMENT *Heating:ELECTRIC *Cooling:NONE <br /> *Date of sale:03/272018 *Sales price:$127,796.00 *Includes land:D Yes 0 No <br /> ,°r ' DEALERT If�FORMATIONp(if no,deaIer,cleave&blank) h , ` x , <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> HOMES DIRECT OF OREGON MSD523 3838 PALM HARBOR DR NE <br /> MILLERSBURG, OR 97321 <br /> 541-928-2083 <br /> ['This manufactured structure is free and clear of all mortgages, deeds of trust,sectuity 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 thebest 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): De ler signature: Date: <br /> NEILA WHITE /� / 06/26/2018 <br /> TRANSPORTER=INFORMA} TION (if not nloving,jlea ',blank) . c� F P14 <br /> 3-� <br /> Transporter name: Transporter address and phone: <br /> BENNETT TRUCK TRANSPORT PO BOX 503098n <br /> WHITE CITY, OR 97503 541-879-3444• <br /> � <br /> 440-2952(7/17/COM) Page 2 <br />