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1 <br /> NATURE <br /> ' - • . OF:FILING (check.all.that.applieiy . 1 �� . . <br /> I ❑ C _ st 0 Cliaaorpkawii. F' n: . <br /> f ❑.n.. R —Tty [ty ❑ " - : . . . - - - O Trip permit — -�:■r iej <br /> I <br /> Fricilter: <br /> . APPLICANT'INFORMATION.'. '1 1 <br /> 4 Dealer/seller ❑Lender ❑ Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> I Name:CASCADE FACTORY HOMES,INC <br /> Address(including city,state, and ZIP):590 N, PACIFIC HWY,WOODBURN, OR 97071 I 1 . <br /> 503 <br /> Phone:( ) 981-5314 <br /> Email:CASCADEHOMES@YAHOO.COM ' . <br /> ' HOME;•_INFORMATION (A re�quired� I , <br /> Hone ID number(if known): DMV X-plate number(if known) 0,3 5 5 1i5 <br /> Al v 101-1- - w E v l . 1 <br /> 11 Moving in from another state - <br /> Has no home ID or X-plate because: ❑ Coming out of county deed records 11i <br /> 11 Other: MO I h s been at,65i3 nA -dr 4rSp <br /> Manufacturer:FLEETWOOD HOMES Iviodel:EG14602S I Year;2019 <br /> i <br /> Manufacturer serial number HUD number i 1 1 <br /> ' FLE2100R18-19005A • ORE 541246 ,, <br /> *Number of sections:1 *Square footage: 800 *Number of bedrooms:2 *Number of bathroo psi 2 <br /> *Type of roofing:COMPOSITIO *Type of siding:CEMENT *Heating:ELECTRIC *Cooling:NO <br /> *Date of sale: ' *Sales price:40,703.00 *Includes land: ❑ Yes Ell Nd <br /> DEALER INFORMATION .(if no dealer,_leave'blank) , I ! ii. {- • <br /> I Dealer name: Dealer license number: Dealer address and phone: 4 ' <br /> I CASCADE FACTORY HOMES, INC MSD-41 590 N. PACIFIC HWY <br /> WOODBURN, OR 97071 : - <br /> (503)981-5314 I ` <br /> OThis 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 stricture, ; . <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 /> 1 <br /> I Dealer name (prim): Dealer signature: Date:. 1 , <br /> �• Lyas- V Ji �I <br /> CASCADE FACTORY HOMES, INC _ I� <br /> TRANSPORTER INFORMATION (if not move . g, leave.blank), i•i <br /> Transporter name: Transporter address and phone: <br /> NEWMAN'S MOBILE HOME TRANSPORT P.O. BOX 236 1 <br /> SILVERTON, OR 97381 , ; ' <br /> 503-932-5142 I I : <br /> 4411-2952(7:17/C0NI) Page 2 �� i <br /> i i ; . <br />