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tV? 8 CO3bjNE. wooJ burvi <br /> ,�c <br /> :21c}5 <br /> _...Z.1..4J.:.w.d,,�C `� �h . - - - <br /> 3 41 <br /> ►� t _• s• u *Change ownership E ►.em'li'•n ..• • ' $- • do ' <br /> ICYte r 'ne ro ' Ill r. p ••rte us 3 Trip permit 1 Eriko to tie <br /> r y <br /> v.''�4(ils�l •Al• t� + y IPI �� <br /> ❑. Dealer/seller ❑ Lender ❑ Escrow/title agent ❑ Owner/buyer ❑ Legal representative <br /> Name:HOMES DIRECT OF OREGON <br /> Address(including city,state,and ZIP):3838 PALM HARBOR DR NE, MILLERSBURG, OR 97321 <br /> Phone:541-928-2083 <br /> Email:neilaw3l@gmail.com <br /> *... 6. 4ze��� . �'� <br /> Home ID number(if known): DMV X-plate number(if known): <br /> NEW irn3583o3 <br /> E Moving in from another state <br /> Has no home II)or X-plate because: ❑Coming out of county deed records <br /> ❑Other: <br /> Manufacturer:PALM HARBOR Model:310H D30763C Year:2020 <br /> Manufacturer serial number HUD number <br /> P H H 3100R 19-13654A ORE548948 <br /> PHH3100R19-13654B ORE548949 <br /> *Number of sections:2 *Square footage:2270 *Number of bedrooms:3 *Number of bathrooms:2 <br /> *Type of roofing:.COMP. *Type of siding:VERT.CEMENT *Eleating:HEAT PUMP *Cooling:HEAT PUMP <br /> *Date of sale:11/01/2019 *Sales price:$139,300.00 *Includes land: ❑ Yes *No <br /> r '17 j <br /> "* <,.. .'ti.. o,. • �., <br /> t a f a�4..- <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> HOMES DIRECT OF OREGON MSD523 3838 PALM HARBOR DR NE <br /> MILLERSBURG, OR 97321 <br /> (541)928-2083 <br /> *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 1 understand it is <br /> made for use as evidence in court and is subject to penalty for perjury. <br /> Dealer name (prim): Dealer sinature: IIP Date: <br /> NEILA WHITE l' 7 01/02/2020 <br /> TRANSPORTER INPORMATION:(if,not Moving;leave blank) <br /> Transporter name: Transporter address and phone: <br /> BENNETT TRUCK TRANSPORT PO BOX 503098 <br /> WHITE CITY, OR 97503 (541)879-3444 <br /> 440-2952(7,17,COM) Page 2 <br />