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I, S' 0 <br /> -D. ®b L-c� nco�.s � LD � � 8- <br /> Authentisign ID:3265E5A1•F580-EF11.88CF•002248299057 s ci, if / ci <br /> 7 3 ( 7 <br /> :iN 4TURE'001iLINOAcheck ali that°appIY).: <br /> ❑ New home to MHODS ❑ Adding or removing a co-owner ❑ Demolition(Date: <br /> 0 Used home sale ❑ Recording as real property ❑ Converted to storage <br /> 0 Security interest change 0 Removing from real property status ❑■ Trip Permit <br /> ❑ Transfer by inheritance ❑ Other(please note): <br /> APPL!t ANT,INIFORMATION(please print)i; ,. . .'. ` : <br /> 12 Dealer/Seller ❑Lender 0 Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name. <br /> COMMONWEALTH HOMEOWNER SERVICES Phone:503-244-2300 <br /> (first,middle,last) <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97224 <br /> Email:MEUSA.COOK@CWRES.COM <br /> a ETiON ^ g "0 . . 3.HOME t A''iO Q iformatiotl i 00115 required},.. y ° et ", , `M, iaN <br /> Home ID#: N AAJ OR No Home ID: ❑■ New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer:CLAYTON CD ` t'd 5 <br /> Model:72DRM20402AH24 Year2024 / <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> ALB0437580RA ORE 565345 <br /> ALB0437580RB ORE 565346 <br /> #of Sections: 2 " . Sq.footage::840 Bedrooms: 2 Bathrooms:'2 <br /> Roofing type: COMP2 Siding type: vet Smart Panel Heating type: ELECTRIC Cooling type: NONE. <br /> Date of sale: Sale rice: Includes land: ❑Yes ■ No <br /> (IfapPlk�abte) l��a-'S`c�� P �Qt1��� ❑ <br /> 1 TlOi�i 1y� , DEALERI iFORIONa(leave biankst#nadealer' °*e <br /> MAT <br /> Name:COMMONWEALTH HOMEOWNER SERVICES,INC. License#:MSD508 <br /> (/irst,middle,last) <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR 'ZIP:97224 <br /> Email: Phone: <br /> I hereby declare 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 or my interest in it.The information listed is true to the best of my knowledge and <br /> belief,and I understand it can be used as evidence in court and is subject to a penalty of perjury. -- <br /> Signature: [Chr;�'�ue-nsey Date: 12/02/24 <br /> ��uC�TyyIO # t sJ F . 3 1, ti + HOME OOw„A IO� i i v 1 i e B a r ka ° <br /> Current Address:2445 PACIFIC BLVD SW <br /> CityALBANY County:LINN State:OR Zip:97321 <br /> Park Name:(if applicable) ' 0 This is a dealer lot or storage facility <br /> 0 This home is being moved to a new location Complete the section below <br /> New Address:2200 LANCASTER DRIVE SE,SP.#18D <br /> City:SALEM County:MARION State:OR Zip:97317 <br /> Park Name: (if applicable) SUNDIAL MHP ❑This is a dealer lot or storage facility <br /> Transporter Name:NEWMAN;S MOBILE HOME TRANSPORT Phone:503-932-5142 <br /> Address:PO BOX 236 City:SILVERTON State:OR <br /> Email: <br /> Page 2 <br />