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603614
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Last modified
7/12/2022 12:59:53 PM
Creation date
12/10/2021 1:08:06 PM
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Assessor
Account Number
603614
Assessor Doc Type
Trip Permit
Doc Type Date
12/9/2021
MTL
081E300001000
Assessor Section
Manufactured Structures
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• <br /> NEW SECURITY-INTEREST HOLDERS <br /> Security-interest holder name: <br /> Mailing address: <br /> Security-interest holder name: <br /> a <br /> Mailing address: <br /> •U <br /> Buyer/new owner acknowledgement of sale/change of ownership <br /> • <br /> • I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the <br /> • sale/change of ownership. <br /> 4,1 I understand that the home cannot be relocated without first completing this form and purchasing a trip permit from the <br /> State of Oregon,Building Codes Division or one of its county agents. <br /> EEI understand that the seller/owner is responsible for submittingthis OwnershipDocument Application to the State of <br /> P PP <br /> 3 Oregon,BuildingCodes Division or one of its countyagents within 30 days after closing of the sale,and that all <br /> �, g g <br /> aeller <br /> buyers and sellers will be notified by mail when the application is completed.I understand that,should the seller/owner <br /> / <br /> L.• fail to file this OwnershipDocument Application within 30 days,I may complete the filing[ORS 446.641(1)].I further <br /> PP <br /> • understand that each lessor,mortgagee,trust-deed beneficiary, lien holder of record,and security-interest holder must <br /> be listed on this notice,or,if none are listed,the manufactured structure must be free and clear of all mortgages, deeds <br /> of trust,security interests,and liens. <br /> Buyer/new owner name(print): Right of survivorship Buyer/new owner signature: Date: <br /> Kent A Purdy <br /> Buyer/new owner name(print): Q Right of survivorship Buyer/new owner signature: Date: <br /> • Denise K Purdy • <br /> • Buyer/new owner name(print): ❑Right of survivorship Buyer/new owner signature: Date: <br /> Pa <br /> Buyer/new owner name(print): ❑Right of survivorship Buyer/new owner signature: Date: <br /> • <br /> Seller/current owner acknowledgement of sale/change of ownership <br /> Application must be accompanied by the appropriate valid County Manufactured Home Notification form. <br /> All owners must release their interest or acknowledge this sale/change of ownership in the structure in order to <br /> complete this application.All current owners,including security-interest holders,must acknowledge the sale/change of <br /> ownership by signing the ownership document or DMV title or completing the section below. Security-interest holders <br /> may elect to acknowledge the sale/change of ownership,but maintain their security interest until such time as they no <br /> longer have an interest in the home. <br /> Seller/current owner affidavit <br /> I affirm that I am the current owner of this structure and acknowledge that the seller is responsible for submitting notice <br /> of sale/change of ownership to the State of Oregon Building Codes Division or one of its county agents within 30 days of <br /> the closing of the sale [ORS 446.641(1)]. <br /> 440-2952(7/19/COM) Page 4 <br />
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