|
e[-son
<br /> 'L 5 ,i. -zmet$4 � Gieit ^iii � ee �a l" G# k � h, a
<br /> I
<br /> , }
<br /> .•g s-c.r' - e- r • ,, d s - ► ►- '.. as - •
<br /> [1 ,•®eyyc��o, _'n_ . re. .rt.:ip : ' -' o '._ o. e, - : s U Tripkpeftliit er- to age
<br /> ✓,t1-r" �r t d [ip"' '°,+,r_" t 7 zY^: "�X +r. u y, ,� :vi+'. X14'& ' ...f-::>sr�.,/.� /�r{'(�+•+ -w • v `' gh1C�q U� ylia' �j '..�+.
<br /> �' x. +`u�r�_ � }a4 � P`�L�'��� � M/'1��I11JR.,,�� �' 4rx r ' .c^i :°�r�n4. ':.. .,w`� �.
<br /> ¢':. arm •.'Sx�..... d .Y_...}_�+:, ajrt �" a;'S a'rt�._ x'�
<br /> j Dealer/seller ❑Lender ❑Escrow/title agent ❑ Owner/buyer ❑Legal representative
<br /> Name: J & M Homes, LLC
<br /> Address(including city,state, and ZIP):12901 SE 97th Ave.#100 Clackamas, OR 97015
<br /> Phone: 503-908-8166
<br /> Email:bbaxter@landmhomes.com
<br /> c n.s• &
<br /> IHM4-400,
<br /> -v�.V.,�. wrs a._u°.s,.a .:;r. r "� '"c at'� '3i��' .� 5'Y �"c`� `w
<br /> �� � �� �O � IrO M Qty re �J�red) { x . .. � >
<br /> .x�y tTjy}rvl/ , y ss�.�..hs c.. �'3,w,...-< :
<br /> Home ID number(if known): DMV X-plate number(if known):
<br /> NEW
<br /> ❑Moving in from another state
<br /> -Has no home ID or X-plate because: ❑Coming out of county deed records
<br /> Other:Brand new home
<br /> Manufacturer:CMH Model:72DRM28563DH19 Year:2019
<br /> .ti x
<br /> Manufacturerserial number x, I$UD number
<br /> ALB0391920RA
<br /> ALB039192ORB
<br /> *Number of sections:2 *Square footage:1512 *Number of bedrooms:3 *Number of bathrooms:2
<br /> *Type of roofing:Architectural *Type of siding:Vertical wood *Heating: *Cooling:
<br /> *Date of sale:9/9/19 *Sales price:86000 *Includes land:❑Yes 0 No
<br /> � r �` � y ,� � �, x ° '�' =`�" '`'` i�°��"� "k�` z"4r{ a �' .. � r.� '� ,. '�.,.�t�¢ `�� �.� �1,�
<br /> `ssr*>W,.�a: �r .�`r.r^d ::,�>'I '"t+�»,Ew3'�ro a` �S'.,t�,i:��.r;. ate:^T:4..s._i�abr�.�»F•* ��„ '` :,r- M,�; .a..
<br /> 411
<br /> Dealer name: Dealer license number: Dealer address and phone:
<br /> J &M Homes, LLC MSD155 12901 SE 97th Ave. #100
<br /> Clackamas, OR 97015
<br /> 503-908-8166
<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 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): • Dea .signature: Date:
<br /> J & M Homes, LLC I/ 6 ,
<br /> y'Kr y-'rvY. T -r p �eH �5":l;?,Y�th'�':2..
<br /> � -�,:.; P, NSP,O TE {I �JRM 11OpidiVnot tpoving l a ebb ,.,
<br /> 'a' J 1' 1#i'.,.s ts8 x> u'x� 3Szfi_.'Y�.v�r 5,Wr`,a. .x :..�. # � "�< ± .cn,....t Al
<br /> ��z ���,:, � ,s s'N.�. ��w.s�� �w r�,�..
<br /> Transporter name: Transporter address and phone:
<br /> 440-2952(7/17/COM) Page 2
<br />
|