Laserfiche WebLink
1 . <br /> 1 . . <br /> . <br />^. • . _49 Y 5 ' .e_' \ - R ~0 k- <br /> - <br /> ` NATURE OF FILING (checkmUthatapp|bes) <br /> r],c41cc <br /> INFORMATIONAPPLICANT <br /> �� __ �IMI Owner/buyer I El al <br /> Numc:Ambe]MomosLLC ___________________________ _______________ <br /> ��� �� _����� <br /> Address(including state,und2|P)�01 Si�� Cou¢ bmAboo CA 94024 _____�_�_ ____ ____ _ • <br /> 1 __' ____ _--_' -�-� � <br /> Phone:253-221'1757 ________ <br /> [moi|:dom�amberhomooLLC©gmaiioom • _ <br /> ` <br /> HOME INFORMATION (* required) __ <br /> - <br /> Home |Dnumber(if6/,ox'n):. DMV------------------- ucmmhcr(rf6nonn): <br /> ~� 2- 0r��� <br /> _ __ _________ � � � _ __ ' � " e��'� '---'~� -------' <br /> ' � | Moving in from another state <br /> • <br /> ||xsnohomc |DorX'p}mchcuousc r Coming oLli olcounty decd records <br /> Ail <br /> ng produced at the factory • <br /> ������������'�������'������__'- <br /> WiunufaouocShyline | Modc|:VVeotridgo1218CT | YmcZUlV <br /> — <br /> Manufacturer serial number HUD number <br /> BZ-91-0198-L-B <br /> BZ'91'0188'L-A <br /> -- ------ ----- <br /> - <br /> *Number of sections:2 t*Square footage:1419 I *Number of bedrooms:3 *NuMber of bathrooms:2 <br /> '— --- <br /> *Type of roofing:shingleS1 ^-* |cuing:o|odh1_*Cooling: <br /> o <br /> - <br /> *Date of sale: 1 *Sales price: | *Includes land: Ei Yes 1:1 No <br /> DEALER INFORMATION (if nmdea|g� leave b�ok) <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> Amber Homes LLC MSD621 201 Silvia Court <br /> Los Altos, CA 94024 <br /> 253-221-1757 <br /> El 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 abqve statement is true to the best of my knowledge and belief,and that I understand it is <br /> made for use as evidence icourt and issubject topono|tvknpx�ury._. <br /> 'n| rsignut�^: Date: �l - 1 <br /> 7 <br /> � | y / / | <br /> 46 -[7�] | � <br /> �" �/ /U'��/ \ / ' -- /-� ~ ' �-- <br /> . TRANSPORTER |NFORMAT|O (ifnot moving, leave blank) • <br /> _-_--__--_-___----�__-___-'___--_---__ <br /> Transporter name: ! Transporter address and phone: <br /> • Blue Haul 1690 Harvey St SE, Jefferson, OR 97352 <br /> , 971'218'3508 <br /> | ________�___ _ <br /> -1-10-2952m/7/cow> Page <br /> . <br />