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<br /> I further certify that each lessor, mortgagee, trust-deed beneficiary, lien holder of record, and security-interest
<br /> • holder has been listed on this notice,or if none are listed, that this structure is free and clear I al of all
<br /> deeds of trust,securityinterests,and liens and that mortgages,
<br /> a I have the legal right to sell this manufactured structure.
<br /> Seller/current owner name(print); Seller/current owner signature: Date: O I release my interest in this structure,
<br /> Alta Clma Corp.
<br /> Phone: 77/4 /Cgr�,�L¢�� 01/04/2022 in I acknowledge this sale/change of ownership,
<br /> Email: but do not release my interest In(ho structure,
<br /> Seller/current owner name(print): Seiler/current owner signature; Date: ❑ I release my interest in this structure.
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<br /> Phone: I acknowledge(his sole/change of ownership,
<br /> Email: ❑ but do not release my interest in the structure,
<br /> Seller/current owner name(print)t Seller/current owner signature: Date: ❑ I release my interest in this structure.
<br /> Phone: I acknowledge this sale/change ofowmership,
<br /> Email:
<br /> in but do not release my interest in the structure.
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<br /> Seller:/current owner name(print): Seller/current owner signature: Date: ❑ I release my interest in this structure.
<br /> • Phone; I acknowledge this aole/change of ownership,
<br /> bSE'.11 na11: inbut do not release my interest in the structure.
<br /> (s!rti"t,{rJ 911 u,r. .�.;.{f.�fiAi�• .•/.4?.1'il i"�7Y1:•� }j r.li <: L5
<br /> A Yb /rk fR1b'ia/ •
<br /> r..,.'.•—• ::Security holder's signature: Date: 01 I releasesty interest In this structure.Security holder's name(mini):
<br /> ❑ I acknowledge this sate/chengef of osynership,
<br /> but do not release my Interest in lie structure.
<br /> Security holder's signature: Date: 0 I release my Interest in this structure.
<br /> Security holder's name(prim):
<br /> •
<br /> t acknowledge This sale/cltnnge of ownership,
<br /> y.t^`3;'!'r'j', al.),,,,,;•;���f .k%��,1.•;?rg ,,�,ll1,7:;.y,r•: ;f. ;y ,nl„ ,,t1,',(,u1r, ❑ but do y ructurc,
<br /> not rcicase nl in(crest in the st
<br /> •o, 1:.,1.dA••.Y';•4gri,t. .Y .$1,4 :,Irv'} f�P. , �j ^•"7"'F!rt"'`Y✓:.V.,n•:..,:�:.,
<br /> Jr.d1 y. ,�'vr+:+t-4'.?+44 vi�5 :.w.IJ•,./0ip' '',.{_ '� r�{�M{ t��f "k.yl� �{1�',f�, C C,l�,r',,(,p�.�}f(• ;;I,:y:,..ic :r's;tt:;.;:;•::;:',;;�;rr �'•.,.
<br /> . ..a' .�...,. ilhf -.. 4• }�;0:5714!) � ��U�MI;firTl'lV�'lU��:IJ/�i1,1��Grr-W{GLIJ
<br /> • lki •, �t�l^:•,r..l,;;.:•�;•.� r-•.t.,�:.., ,.,nl r r,J :r r ' Ir z 1,
<br /> ❑ Signatures from all applicable parties must be complete(current owners/sellers,new owners/buyers,and security
<br /> interest holders),
<br /> ❑ A valid tax certification from the county tax assessor.The tax certification form will be provided by the county
<br /> office and must be signed by a county official.
<br /> Any additional documents
<br /> ❑ needed td establish your authority to buy/sell this home as required
<br /> YORS
<br /> and OAR 918 and posted at www.oregon,gov/bcd. 9 by 446
<br /> If the home is being moved to a different county,a valid tax certification form is needed from both:
<br /> ❑ (A)the county the home is moving from and
<br /> B
<br /> O the county the home will be moved to •
<br /> if recording in or removing from countydeed records,you must
<br /> ❑ also submit a copyof the recorded(Form 5176 or 5175 found at www•oregon.gov/bcd).
<br /> ❑ If signing by Power of Attorney, submit a Change Affidavit(Form 5221),
<br /> 0 If this application is being submitted by the seller,you must also submit a bill of sale.
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<br /> 440-2952(7/I9/C0M) Page 5 •
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