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, ID , Salem 9130C, <br /> ) Co 5 D. IA-) i I 4-56 j Ck ° 8 t <br /> __ ___ <br /> ____, _ _. , _ __, <br /> . <br /> SECTION 1 - . NATURE OF FILING(check all that aPP Y I ) _v_ <br /> ❑■ New home to MHODS kl2kAlitirVvitetleviliglitib6tarter VIVItt yila(C)ute >) <br /> [Cf' sib ren-stale _ - ErRg >affaktilets t I _ _ EVV61e6dt fd.efo age <br /> 12\asktrafilift.rdrEhenge er g P pr e ams i❑ Trip Permit <br /> _riZ p ace _ cr\CAli ssiketle):_. - <br /> SECTION 2 APPLICANT INFORMATION(please print) <br /> d Dealer/Seller ❑Lender ❑Escrow/Title Agent ❑Owner/Buyer D Legal Representative <br /> Name:Trl CityMobiles Estates LLC . Phone:503-522-0856 <br /> (first,middle,lust) <br /> Address:PO Box 10 <br /> City:Sandy State:OR ZIP:97055 <br /> Email:trimblerentals@gmail.com - - <br /> SECTION 3 HOME HilkiRMATION(information in bold is required) _ <br /> Home ID#: OR No Home ID: 'Q New Home ❑Out of state home ❑Leaving County Deed Records <br /> Manufacturer:Cavco 601 3`15D _ <br /> Model:210EV24482E Year: 2026 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> CAV2100R26-25616A. - ORE 571545 <br /> CAV210OR26-25616B ORE 571546 _ - - <br /> #of Sections: 2 Sq.footage: 1,072 Bedrooms: 3 Bathrooms: 2 <br /> Roofingtype: architectural composite Sidin e: vertical cement Heatingtype: electric type: n/a <br /> g tYP Cooling <br /> Date of sale: 3/31/26 Sale price: $91,745 Includes land: ❑Yes 0No <br /> alapplicable) - <br /> _ SECTION 4 DEALER INFORMATION(leave blank if no dealer) <br /> Na"e:Tri CityMobile Estates LLC License#:MSD 1091 <br /> (first,middle,last) <br /> Address:PO Box 10 ' <br /> City:Sandy State:OR ZIP:97055 <br /> Email:trimblerentals@gmail.com Phone:503-522-0856 <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 /> Signature: nd it can be used as evidence in court and is subject to a penalty of perjury. <br /> belief,andunderstand c� Date:3/31/26 <br /> - --- - - <br /> SECTION 5 HOME LOCATION <br /> Current Address:2655 Progress Way __ <br /> City:Woodburn County:Marion State:OR Zip:97071 <br /> Park Name: (if applicable) ❑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:1652 Wiltsey Road, Lot 12 _ _ _ <br /> - - - <br /> City:Salem County:Marion State:OR Zip:97306 <br /> Park Name: i applicable) Brookside Mobile Home Park ['This is a dealer lot or storage facility <br /> (.f <br /> Transporter Name:Doug's Mobile Home Service - Phone: 503-799-0539 <br /> Address:12692 Fry Road NE City: Aurora State: OR <br /> Email:dugwalton@aol.com <br /> Page 2 <br />