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• . <br /> NATURE OF FILING(check:all that applies) ' <br /> h e s it er an e nec D of 'on e e lti . <br /> N. e mg al ert m 1 frbti re r e status 11] Trip permit n er to s age <br /> Other:NEW HOME <br /> APPLICANT INFORMATION .' <br /> ❑■ 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.COOK@CWRES.COM <br /> HOME°INFORMATION (' requited) <br /> Home ID number(if known): DMV X-plate number(if known): �/'',,`�! _ '�/' <br /> TBD . lU 0 O� O`er <br /> ❑ Moving in from another state <br /> Has no home ID or X-plate because: n Coming out of county deed records <br /> n 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 /> DEALER INFORMATION (if no dealer, leave blank) <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 /> • <br /> TRANSPORTER.INFORMATION (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 />