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<br /> ■❑Dealer/seller ❑Lender ❑Escrow/title agent ❑ Owner/buyer y Legal❑ representative
<br /> Name:Factory Expo Homes
<br /> Address(including city,state,and ZIP):2555 Progress Way,Woodburn, OR. 97071
<br /> Phone:503-981-0770
<br /> Email:mocon(nell@factoryexpohomes.com
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<br /> Home ID number(f known): DMV X-plate number(if known):
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<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:Fleetwood I Model: Redding 28483T I Year: 2021
<br /> Manufacturer serial number. . • HUD number
<br /> FLE2100R20-20831A ORE 553020
<br /> FLE2100R20-20831 B ORE 5530,21
<br /> *Number of sections: _2 1 *Square footage: 1279 1 *Number of bedrooms:3 *Number of bathrooms: 2
<br /> *Type of roofing:Arch. Comp. 1 *Type of siding:Vert. Cement *Heating: Electric I *Cooling: None
<br /> *Date of sale: 05/13/2020 *Sales price: 55,644.00 *Includes land:❑Yes MNo
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<br /> Dealer name: Dealer license number: Dealer address and phone:
<br /> Alta Cima Corp. - MSD 448 2555 Progress Way
<br /> Dba: Factory Expo Homes Woodburn, OR, 97071
<br /> [1]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 /> Alta Cima Corp. /C�h07/23/2020
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<br /> Transporter name: • Transporter address and phone:
<br /> Blue Haul Transport 38282 Hungry Hill Rd.
<br /> Scio, OR. 97374
<br /> 440-2952(7/19/COM) Page 2
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