Laserfiche WebLink
btcuSi n Envelo e ID:67C8F4D6-8AEA-47B7-AC47-6ED2F2F2F3CA i i^ <br /> 9 f p 1� �o (-14. <br /> d�� t I LI L SE e V' - ir,n <br /> NATUREOF""FILING (check;all that app.ies) <br /> s ur' ter Change ownership io1 o <br /> 04‘,",de'vg.,.perfed115Th- eTf> 17, ' : ,v' g • --:l ' o.-rt, . u al '"• p-- ' \1 . .n -rte. : s : :_e <br /> APPLICANTINFORMATION <br /> ■❑ Dealer/seller ❑ Lender ❑ Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name: Factory Expo Homes <br /> Address(including city,state, and ZIP): 2555 Progress Way, Woodburn, OR. 97071 <br /> Phone: 503-981-0770 <br /> Email: moconnell@factoryexpohomes.com <br /> 'HOMIN <br /> E FORMATION;(*Ireq�u red)_ . <br /> Home ID number(if known): DMV X-plate number(if known): <br /> \JEVJ rnf-235-138-7 <br /> ❑ Moving in from another state <br /> Has no home ID or X-plate because: ❑ Coming out of county deed records <br /> ❑ Other: <br /> Manufacturer: Fleetwood Model: EV2 24362V Year: 2020 <br /> Manufacturer serial number HUD number <br /> FLE210OR19-20098A <br /> FLE2100R19-200988 <br /> *Number of sections: 2 *Square footage: 839 *Number of bedrooms: 2 *Number of bathrooms: 1 <br /> *Type of roofing: Arch. Comp.. *Type of siding: Vert. Cement *Heating: Gas *Cooling: None <br /> *Date of sale: 04/30/2019 *Sales price: 53,327.00 *Includes land: ❑ Yes 0 No <br /> DEALER INFORMATION H.(if no.dealer, leave blank) " <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> Alta Cima Corp" MSD 448 2555 Progress Way <br /> Dba: Factory Expo Homes Woodburn, OR. 97071 <br /> O 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. <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 /> Dealer name (print): Deal-r signature. Date: <br /> Alta Cima Corp / d ( `• - / / 08/23/2019 <br /> ,TRANSPORTER.INFORMATION if not morrrng,leave blank) <br /> Transporter name: Transporter address and phone: <br /> Superior Home Transport, LLC PO Box 1067 <br /> Jefferson, OR. 97352 <br /> 440-2952(7/19/COM) Page 2 <br />