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<br /> 0 Dealer/seller I 0 Lender I 0 Escrow/title agent 1 El Owner/buyer ( 0 Legal representative
<br /> Name:Dougs Mobile Home Service INC
<br /> Address(including city,state,and ZIP):12692 Fry rd Aurora or 97002
<br /> Phone:503-799-0539
<br /> Email:dugvvalton@aol.corn
<br /> ,... k 94 0.040:(j.k0*110 0-0.•,:iio,4: ::,-il .-::::i:.:.fl'i,: ::;:4!:::: : .: :•:.:, ._-.E:.1.:!..':,..%,-,..-. ._:::
<br /> Home ID n124113.q.,(140 P.111.2):,,,,,,,i, , DMV X-plate number W known):
<br /> 4:-Z-i4.2444.4661- ?-.,e1 ‘71,1 1 2 609
<br /> , .-:,„-,,,,,, .,,...
<br /> 0 Moving in from another state
<br /> Has no home ID or X-plate because: 00 Coming out of county deed records
<br /> Other:
<br /> Manufacturer:
<br /> Model: I Year:
<br /> Manufacturer serial an limber I ECJD number
<br /> 6 e et_ LI 64 i c 1 z t-ilo 61 0 . 6'2 t.29 ?lc .
<br /> C) 62 PL. (1, L00 i 9 2-14 76 6) 012 E 2 6,9 f7-th0..'i
<br /> *Number of sections: .2 i *square footage:/5-12,I *Number of bedrooms: 3 I *Number of bathrooms: Z.
<br /> *Type of roofing: efiryyke 1 *Type of siding: i - L* I *Heating: fled& 1 *Cooling: MiV.E...
<br /> *Date of sale: i i)y / ci i *Sales price: i 0 00, co *Includes land:0 Yes 5:61"o
<br /> PEAMI:IINORMATOC)M:(Itn660 -1100*-1QNifik) ;,::. ..,,: :;.;::.::; .; ••_,:„:f::.::. ,:::'::;..::
<br /> Dealer name: - Dealer license number: Dealer address and phone:
<br /> Dougs Mobile Home Service INC 652
<br /> 12692 Fry rd Aurora or 97002
<br /> 503-799-0539
<br /> 0 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 /> II hereby declare that the above statement is true to the best of my knowledge and belief,and that II understand it is
<br /> made for use as evidence in court and is subject to penalty for perjury.
<br /> Dealer name 6n^int): Dealer signa :"/(,,i/ I Date:
<br /> Doug Walton
<br /> ez—ti--I at
<br /> :,-:---:':,--- TRANSPORTERillEIFOREATIlakttf •97 ° A TA ' k) . •. ' ' -' :- '
<br /> Transporter name: Transporter address and phone:
<br /> Dougs Mobile Home Service INC 12692 Fry rd Aurora or 97002
<br /> 440-2952(7/17/COM)
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