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I • _� <br /> `7.-1 5 j Checc°et,aitoOxe_rb <br /> NATURE OF FILING:(check'all:that_applies) ' • <br /> [19141 carr et t lit Change ownership ❑ ! molin.• ► e o o- 1• - . <br /> R n a ea ro r.• e ovi • fr.n rt ro r .s • is ❑® Trip permit t to ge <br /> t�..t,•Ot�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:CASCADEHOMES@YAHOO.COM <br /> Home ID number(if known): DMV X-plate number(if known): <br /> NEW , , ` 35 84('7 <br /> ❑ Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> ❑ Other: <br /> • <br /> Manufacturer:FLEETWOOD Model:EG28443S Year:2020 <br /> Manufacturer serial number HUD number <br /> FLEOOR19-20070A ORE 548656 <br /> FLE2100R19-20070B ORE 548657 <br /> *Number of sections:2 *Square footage: 1173 *Ntunber of bedrooms:3 *Number of bathroonms:2 <br /> *Type of roofing:COMPOSITIO *Type of siding;CEMENT *Heating:ELECTRIC *Cooling:NO <br /> *Date of sale:6-27-19 *Sales price:54,837.00 *Includes land: ❑ Yes Q 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 signature: Date: <br /> CASCADE FACTORY HOMES, INC <br /> 'TRANSPORTER INFORMATION:11f not moving, leave-blank) <br /> Transporter name: 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 />