STATE OF CALIFORNIA BUSINESS TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF - PDF

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STATE OF CALIFORNIA BUSINESS TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF - PDF Powered By Docstoc
					                                                                  STATE OF CALIFORNIA
                                                    BUSINESS, TRANSPORTATION AND HOUSING AGENCY
                                                  DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
                                                           DIVISION OF CODES AND STANDARDS
                                                          REGISTRATION AND TITLING PROGRAM

                                NOTICE OF INTENT TO MOVE A MANUFACTURED HOME,
                         MOBILEHOME, MULTI-UNIT MANUFACTURED HOUSING, OR FLOATING HOME
                                      WITHOUT CONSENT OF SECURED PARTY
SECTION I.            INSTRUCTIONS
1.    Applicant, complete Sections II through VI. Attach the white copy to the “Notice of Situs Change for
      Manufactured Home, Mobilehome, Multi-unit Manufactured Housing, or Floating Home” form HCD 480.9.

2.           Deliver the yellow copy to the transporter.

3.           Mail pink copy to the secured party.

SECTION II.                       DESCRIPTION OF UNIT

The Decal (License) Number(s) is:

The Trade Name is:

The Serial Number(s) is:

SECTION III.                      APPLICANT INFORMATION

Name:

Mailing Address:
                     Street Address or P.O. Box                                 City                                State             Zip


SECTION IV.                       SECURED PARTY INFORMATION

Name:

Mailing Address:
                     Street Address or P.O. Box                                 City                                State             Zip

Check Appropriate Box:                            Legal Owner,               Junior Lienholder

SECTION V.                        SITUS INFORMATION

New Situs Address is:
                                  Street Address/Space No.                               City              County             State         Zip

Old Situs Address is:
                                  Street Address/Space No.                               City              County             State         Zip


SECTION VI.                       CERTIFICATION
A request for consent to move the manufactured home, mobilehome, multi-unit manufactured housing, or floating home described above from the
current situs address to the proposed situs address was mailed by certified mail or delivered to the secured party named above. Thirty (30) days
have passed since the request was mailed or delivered and the secured party has neither given nor withheld consent. It is the intent of the above-
mentioned applicant to move the manufactured home, mobilehome, multi-unit manufactured housing, or floating home on
_________/__________/___________.
     Month         Day              Year

I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.


Executed on                                at
                         (Date)                                     (City)                                          (State)



Applicant Signature:
HCD 481.5 (7/97)