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I <br /> r4k <br /> gilo Avt Se T <br /> NATURE OF FILING (check all that applies) <br /> !- s 1\ ni-ry t lion II 'ae • : <br /> " iLIE s El Trip permit (24cialtsytaUstypte <br /> r""e6tileer: <br /> APPLICANT INFORMATION <br /> EJ Dealer/seller Lender Escrow/title agent D Owner/buyer El 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 INFORMATION (*.required) . . . . . <br /> Home ID number(if known): DMV X-plate number(if known): <br /> NEW if-VI 3 ‘ '.7 (i7 <br /> 0 Moving in from another state. <br /> Has no'flume ID or X-plaie because. E Coming oui of couniy deed records <br /> 0 Other: <br /> Manufacturer:FLEETWOOD HOMES Model:EAGLE EG28483S Year:2019 <br /> Manufacturer serial number S HUD number <br /> FLE2100R18-19390A .ORE 544165. <br /> FLE2100R18-19390B ORE 544166 <br /> *Number of sections:2 *Square footage::1279 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofing:COMPOSITIO *Type of siding:CEMENT *Heating:ELECTRIC *Cooling:NO <br /> *Date of sale: I *Sales price:63,026.00 I *Includes land: D Yes El 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 /> M 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 /> CASCADE FACTORY HOMES, INC <br /> TRANSPORTER INFORMATION (if not moving, leave blank) <br /> Transporter mune: Transporter address and phone: <br /> NEWMAN'S MOBILE HOME TRANSPORT P 0 BOX 236 <br /> SILVERTON, OR 97381 <br /> 503-932-5142 <br /> 440-2952(7/17/COM) Page 2 <br />