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(0331 LiShck tog , vevi-un <br /> . . 3.1 Cr <br /> r 5t ° Pp. <br /> fl k <br /> .�M r. �':. C.'i.r:_ <br /> e e v' A, li:1,11 1. wShy' n: <br /> [],UNiil 'vi' V ( ),/kjicky.itINEraveaLlevrAsisx,tztus ❑Trip permit LAp s <br /> joieagt <br /> ( r;!„ C ' . � vi � voNRx �� r+ +ctfm g�? � ts <br /> ? Lr Y . w �: d <br /> t$ . <br /> ❑ir Dealer/seller ❑ Lender ❑ Escrow/title agent I ❑ Owner/buyer . I ❑ Legal representative <br /> Name:J&M Homes, LLC -- <br /> Address(including city,state,and ZIP): 12901 SE 97th Ave.#100 Clackamas, OR 97015 <br /> Phone: 503-908-8166 <br /> Email: bbaxter©jandmhomes.com <br /> ypti 2 srte , vaCv}. .{.�.-r es.x a . i. I* h yv, <br /> M SWavi fi •C1ortE rNOM ltiy!� SMGi•Ujdl 'x'.K•4u e1rgn+ 5�c"44iv1-.' tai^ft..;lv�., <br /> Home F 6,. <br /> ^tG' <br /> I D number(if known): DMV X-plate number(if known): <br /> NAS/ \ 35-15 D-2 <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:CMH MFG West,Albany Model:ING761 F I Year:2019 <br /> Manufacturer serial number HUD number <br /> ALB0385330RA <br /> ALB0385330RB <br /> *Number of sections:2 *Square footage:2052 *Number of bedrooms:4 *Number of bathrooms:2 <br /> *Type of roofing:Comp I *Type of siding:Wood I *Heating:Elec I *Cooling:No <br /> *Date of sale:01/29/2019y *Sales price:$118,900 *Includes land:❑Yes 0 No <br /> aw.k"e .:""' ' '�}"'ia..i , u�..+Ftf'ros'_:isys "'� ,r 1 �.. <br /> . �i $ X c . tti. .,. .: +' �`at.>• Y`��`• u'%_]'=s'.. N .-+G RMI" - <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> J&M Homes, LLC MSD155 2109 SE 97th Ave.#100 <br /> Clackamas,OR 97015 <br /> 503-908-8166 <br /> This manufactured structure is free and clear of all mortgages,deeds of trust,security interests,and liens.I havethe <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 /> Deale si natu : Date: <br /> Dealer name(print): g <br /> � P 2 "I <br /> J&M Homes, LLC 5' <br /> ._ ax" y RTE e © _ f�v�- aiii � i. . <br /> � 4,. ,, 3*' a `•.i�1P.z£iY "," a3 v �. t_S' <br /> Transporter name: Transporter address and phone: <br /> J &M Homes, LLC 2109 SE 97th Ave. #100 <br /> Clackamas, OR 97015 <br /> 503-908-8166 <br /> 440-2952(7/I7ICOM) Page 2 <br />