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- Lanccis R ,S kh„, 9 -731-7 <br /> NATURE OF FILING (check all that.applies) <br /> [ e� kllfhzerest ❑ Change ownership U n o ' ' . <br /> e m e p n ' gi m a o er s ' per • o orage <br /> El Other:NEW HOME <br /> APPLICANT INFORMATION <br /> ❑1 Dealer/seller. ❑ Lender ❑ Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name:COMMONWEALTH HOMEOWNER SERVICES <br /> Address(including city,state,and ZIP): 18150 SW BOONES FERRY ROAD, PORTLAND, OR 97224 <br /> Phone:503-244-2300 <br /> Email:MELISA.000K@CWRES.COM <br /> . HOME INFORMATION'.(* requir"ed) <br /> Home ID number(if known): DMV X-plate number(if known): <br /> TBD _ . <br /> n Moving in from another state <br /> Has no home ID or X-plate because: ❑ Coming out of county deed records <br /> ❑ Other: <br /> Manufacturer:SKYLINE Model:WEST RIDGE Year:2023 <br /> Manufacturer serial number HUD number <br /> 245-000-H-A101484A ORE 560576 <br /> 245-000-H-A101484B ORE 560577 <br /> *Number of sections:2 *Square footage: 1344 *Number of bedrooms:2 *Number of bathrooms:2 <br /> *Type of roofing:COMP *Type of siding:HARDIBOARD *Heating:HEAT PUMP *Cooling:HEAT PUMP <br /> *Date of sale:1-26-23. *Sales price:$145,735 *Includes land: ❑ Yes ❑® No <br /> _ �o <br /> DEALER INFCOI"MATLON tit no dealer;leave.blanky <br /> Dealer name: Dealer license number: Dealer address and phone: <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 /> TRANSPORTERFINFORMATION (If not moving, leave blank) <br /> Transporter name: Transporter address and phone: <br /> Newman's Mobile Home Transport PO Box 236 <br /> Silverton, OR 97381 <br /> 503-932-5142 <br /> 440-2952(7/17/COM) Page 2 <br />