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r---- • <br /> 40 r3 Mara, �1a►�. Rc rnt 14 A <br /> C3 Change secure �i?H4c �'6�;� �b �lp9ri� / <br /> security interest i ❑Change ownership <br /> ❑Recording as real grope tt-•�� ❑Demolition Dare of demolition:kenoving from real property ittor_, <br /> 0 Other. P p ty states 0 Trip Permit <br /> ❑Converted to storage <br /> 10 Dealer/seller 0• - -• • APPLICANT INPORIlfA n iON <br /> Lender 0Escrow/title agent - <br /> Nae:Dougs Mobile Home Service INC I ❑ Owner/uuyer 0 Legal representative <br /> m <br /> Address (including city,state,and ZIP ; <br /> Phone:503-799-0539 ) 1 682 Fry rd Aurora or 97002 <br /> Emai is dugwalton©aol.corn <br /> �I Home D number(fjnown): <br /> i`? aa;S J �r € r. <br /> a , (05 13iv13% -plate number(fknotiin;): <br /> 0 Moving in from <br /> Has no home ID or r- e another state <br /> plat„ because: <br /> ❑Conning out of county deed records <br /> Manufacturer: • <br /> ❑ ether. <br /> / c,rr i <br /> Model: <br /> odel: <br /> anu aetu er serial number �'rL J <br /> ar: 9D <br /> 1 <br /> I r <br /> *Number of sections: I 1 <br /> j �. ::Square footage: _ <br /> *TypeNum e roofing: // *Number of bedrooms: <br /> (4,.•wt., I 3 *!�' beY of bathrooms: <br /> *Type of rns: ,� f <br /> '`Date of sale: i 1 '- ( I *Heating- <br /> �'� 2p ' Sale films 'C_ I ;:Coolig: [ .ex— <br /> s price: c. t,x <br /> �� J °'Includes land: <br /> SAL INFORMATION 0 Yes f�?t`lo <br /> Dealer name: <br /> fjf.aa denier, iea�sblank) <br /> Dougs Mobile Home Service INC Dealer <br /> ler license number; ddes <br /> Dealer address and phone: <br /> 2 <br /> 12692 Fry rd Aurora or 97002 <br /> 503-799-0339 <br /> EIJThis n3anufaced structure is free and cIesi of all wort <br /> legal right to sell this manufactured structure. gages, deeds of trust,secure l <br /> hereby declare that the above statement security interests, and <br /> be,%e ��a�'ei}Zeiri�is true to Liens.I have the <br /> :hare for use asr evidence a caulthe best e,r of my per knowledgeuand belief,and.that` <br /> Dealera and �s subject to penalty fo5•perjury. <br /> . <br /> name (przrtt): n understand it�s <br /> Doug bVafton Dealer si <br /> a'' Date: <br /> u +.§�1SPORT O� fFO llz Td� :div •' moving,��6� .0.-- 00 .`7-e> --a <br /> Transporter name: 9� 9�i4r blank) <br /> Transporter <br /> Dougs Mobile Home Service INC ilsporter address and phone: <br /> 12692 Fry rd Aurora or 97002 <br /> t j <br /> 440- 52(7/17/COM) I <br /> Page 2 <br /> Z'd 66Z L-OOZ-£09 eoinaeg ewoH a qo j s6no4 eL17:1 . '0Z 9Z qed <br />