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V'D S _Wa21-ei I n <br /> ' `Li" S 11( V e-I401/1 <br /> NATURE OF FILING (check all that applies) <br /> e se, 't. i' - ( 'fn.aI Iit'ifn: <br /> KIN7S.d' kpttp.# 5,1,01WketivArApiv9rvisteaft, Trip permit v t> kl\tp to"aie <br /> r: <br /> APPLICANT INFORMATION <br /> 0 Dealer/seller ❑Lender ❑Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name:CASCADE FACTORY HOMES, INC <br /> Address(including city,state,and ZIP):590 N. PACIFIC HWY,WOODBURN,OR 97071 <br /> Phone:(503)981-5314 <br /> Email:JULIE.CASCADEHOMES@YAHOO.COM <br /> HOME E INFORMATION (* required) <br /> Home ID number(if known): DMV X-plate number(if known): <br /> NEW M, 3574D0 <br /> 0 Moving in from another state <br /> Has no home ID or X-plate because: ['Coming out of county deed records <br /> [' Other: <br /> Manufacturer:FLEETWOOD HOMES Model:WAVERLY CREST 28482L Year:20"9 <br /> Manufacturerserial number HUD number <br /> FLE2100R19-19710A ORE 546058 <br /> FLE2100R19-19710B ORE 546059 <br /> *Number of sections:2 *Square footage: 1279 *Number of bedrooms:2 *Number of bathrooms 2 <br /> *Type of roofing:COMPOSITIO *Type of siding:CEMENT *Heating:ELECTRIC *Cooling:NO <br /> *Date of sale:12-2-2018 *Sales price:70,425.00 *Includes land: ❑Yes ❑■ No <br /> DEALER INFORMATION (if no dealer, leave-blank) <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> CASCADE FACTORY HOMES, INC MSD-41 590 N. PACIFIC HWY <br /> WOODBURN, OR 97071 <br /> (503)981-5314 <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 si are. Date: <br /> CASCADE FACTORY HOMES, INC .1 �i <br /> TRANSPORTER INFORMATION (if not movi g, leave blank) <br /> Transporter mmnc: Transporter address and phone: <br /> NEWMAN'S MOBILE HOME TRANSPORT P 0 BOX 236' <br /> SILVERTON,OR 97381 <br /> 503-212-0994 <br /> 4404952(7117/COM) Page 2 <br />