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608584
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Last modified
2/5/2024 11:02:35 PM
Creation date
2/5/2024 11:25:25 AM
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Assessor
Account Number
608584
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
1/18/2024
MTL
072W06BA00800
Assessor Section
Manufactured Structures
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MANUFACTURER'S STATEMENT OR CERTIFICATE OF ORIGIN TO A MANUFACTURED HOME <br /> FIRST ASSIGNMENT <br /> MANUFACTURER:Fleetwood Homes For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> home described therein to: <br /> ADDRESS: 2655 Progress Way,Woodburn,OR 97071 Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> • Street,City,State,and Zip the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Amt.Of Lien Date To Whom Due Address <br /> The undersigned MANUFACTURER hereby certifies that the new manufactured home described below, Dated , at <br /> the property of said MANUFACTURER,has been transferred By: . <br /> this 20th day of April , 2023 on Invoice No 202372173900 Trans <br /> ane(or(Firm Name) Sign Here Position <br /> Dealer License(Permit)No. <br /> Before me personally appeared who by me being <br /> To: JO PROPERTY GROUP LLC duly sworn upon oath says that the statements set forth above are true and correct. <br /> Distributor,Dealer,Etc. Subscribed and sworn to before me this day of <br /> Notary Public for County,State of <br /> Whose Address is: 1700 ADAMS AVENUE SUITE 212 Notary Seal <br /> SECOND ASSIGNMENT <br /> Street For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> COSTA MESA,CA 92626 home described therein to: <br /> City,State,and Zip Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> Trade Name: 210SP-Sandpointe-14522A Model Year: 2023 the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Amt.Of Lien Date To Whom Due Address <br /> Model No: 210SP14522A Body Width Ft: 13'8" <br /> Body Length Ft: 56'0" /Ft: 52'0" Dated , at <br /> By: <br /> Including Hitch Excluding Hitch <br /> Transferor(Firm Name) Sign Here Position <br /> Square Feet: 710 Date of Manufacture: 04/10/2023 Dealer License(Permit)No. <br /> Before me personally appeared who by me being <br /> duly sworn upon oath says that the statements set forth above are true and correct. <br /> Manufacturer's ID No: FLE210OR23-23226A Weight: 20,460 Subscribed and sworn to before me this day of , <br /> Manufacturer's ID No: Weight: Notary Public for County,State of <br /> Manufacturer's ID No: Weight: Timmy Seal <br /> THIRD ASSIGNMENT <br /> Manufacturer's ID No: Weight: For Value Received,the undersigned hereby transfers this Statement of Origin and the manufactured <br /> Manufacturer's ID No: Weight: _ home described therein to: <br /> Manufacturer's ID No: Weight: Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> The CORPORATION further Certifies that-this was the first transfer of such new manufactured home in Amt.Of Lien Date To Whom Due Address <br /> ordinary trade and commerce. <br /> • <br /> Fleetwood Homes Dated , . at <br /> By: <br /> Corporation, Transferor(Firm Na,ne Here <br /> ( ) Sign Position <br /> 1 Dealer License(Permit)No. <br /> By: ( C.J L,(`-r',A:, C ' r\ Before me personally appeared who by me being <br /> Sign Name Tile or Position duly sworn upon oath says that the statements set forth above are true and correct. <br /> -2655 Progress Way,Woodburn,OR 97071 Subscribed and sworn to before me this day of , • <br /> Notary Public for County,State of <br /> Office Address of Signatory(City&State) Notary Seal <br />
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