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1 -D---D-3-(rio SuAD Inr) 14:-J R J , sul01,- ' ' - - - <br /> 1 ory) , ---,-1 - . . <br /> . „ <br /> SECTION 1 - NATURE OF FILING (check all that apply) , <br /> El New home to MHODS it g elud3v 6wner • I A a diiti h(Date: ) <br /> ' l d Xl f ale n 1'lj)o erty rted to storage <br /> ( lAscal ii inter st6hange eg nesn r r r4}Lstatus ❑B Trip Permit <br /> 111,TPusfV.34Ntkitance pjeasuo[e): . <br /> SECTION 2 , ,' APPLICANT INFORMATION (please print) <br /> • 0 Dealer/Seller ❑Lender ❑Escrow/Title Agent ❑OwnerBuyer ❑Legal Representative <br /> -. . -Name:HOMES DIRECT OF OREGON LLC •• Plione:.,541=9.2$-2083.... <br /> (first,middle,last) <br /> . Address:3838PALM HARBOR DR NE <br /> .City:MILLERSBURG State:OR • ZIP:97321 . .... <br /> Email:TANYA.ABADILLA@HOMES.DIRECT <br /> SECTION 3 HOME INFORMATION (information in bold is required) - , <br /> Home ID II:NEW: OR No Home ID: ❑® New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer:CAVCO/ PALM HARBOR <br /> (0I o <br /> a� _ <br /> .Model:.3104.G28562A • Year:2026 . <br /> Serial Number(s) HUD Label Number(s)*Required if new home- <br /> CAV3100R25-16633A ORE 569048 . ' "- - ' <br /> CAV3100R25-16633B ORE 569049 ' -• -- ' <br /> #of Sections: 2 . Sq.footage: 1553 • Bedrooms: 2 Bathrooms: .2* : ` <br /> 'Roofing type: ARCH": - •• Siding type: FIBER CEM Heating type:- ELECTRIC.. -Cooling type:,: NONE:•: <br /> Date of sale: <br /> (ijnppltcnble) 10/23/2025 Sale price: 184,063.00 Includes land: ❑Yes ❑®.No. : <br /> SECTION_4; - •: DEALER``INFORMATION (leave blank If no dealer) , <br /> Name:HOMES DIRECT OF OREGON LLC License#:MSD.523 _. <br /> (first,middle,last)1 . . . . .. <br /> 'Address:3838'PALM HARBOR DR NE , <br /> City:MILLERSBURG State:OR ZIP:97321 1 - . . . . <br /> Email:TANA.ABADILLA@HOMES.DIRECT Phone:541-928-2083 - — . <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 unde . $0 it can be us d s viden i purt and is subject to a penalty of perjury. <br /> Signat c /4) Date: /9./ p <br /> SECTION 5 HOME LOCATION <br /> Current Address:3838 PALM HARBOR DR NE ' <br /> City:MILLERSBURG County:LINN State:OR Zip:97321 <br /> Park Name: (if applicable) ■❑This is a dealer lot or storage facility <br /> El This home is being moved to a new location Complete the section below <br /> ' New Address:12236 SUBLIMITY RD • <br /> City:SUBLIMITY County:MARION State:OR Zip:97385 <br /> . ' .Park Name: (if applicable) ❑This is a dealer lot or storage facility <br /> Transporter Name: BENNETT TRUCKING&TRANSPORT Phone: 541-879-3444 <br /> Address:409 BIGHAM BROWN RD City: EAGLE PT State: OR 97524 <br /> Email:YOR@BENNETTIG.COM <br /> • Page 2 . <br />