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• I further certify that each lessor,mortgagee, trust-deed beneficiary, lien holder of record, and security-interest holder has been listed on this notice, or if none are listed,that this structure is free and clear of all mortgages, deeds of trust, security interests,and liens and that I have the legal right to sell this manufactured structure. Seller/current owner name( riot): Seller/current owner signature: Date: 0 I release my interest in this structure. CASCADE FACTORY HOMES INC 3/16/2022 Phone:503-981-5314 ❑ I acknowledge this sale/change of ownership,- Email:CASCADEHOMES@YAHOO. but do not release my interest in the structure, Seller/current owner name(print): Seller/current owner signature: Date: ❑ I release my interest in this structure. Phone: ri 1--1 I acknowledge this sale/change of ownership, Email: but do not release my interest in the structure. Se;ier/current owner name(print): Seller/current owner signature: Date: ! ?release my interest in this etr,cture. Phone: - n 1 aeknowicdgc this sale anange of ownership. z�i2laliC — but do not re'easc my interest in the strtetur . Seticr:/current owner name(print): Seller/current owner signature: Date: 7 I release my interest in this structure. —_ Phone: 1-11 acknowledge this sale,change of ownership. but do not release my interest in the structure. Email: SECURITY-INTEREST HOLDER ALREADY ON RECORD (if applicable) Security holder's name(print): Security holder's signature: Date: ❑ i release my interest in this structure. ❑ I acknowledge this sale/change of ownership, but do not release my interest in the structure. Security holder's name(print): Security holder's signature: Date: ❑ I release my interest in this structure. ❑ I acknowledge this sale/change of ownership. but do not release my interest in the structure. • PRIOR TO SUBMITTING, CHECK THE FOLLOWING: ❑ Signatures from all applicable parties must be complete(current owners/sellers,new owners/buyers,and security interest holders). ❑ A valid tax certification from the county tax assessor.The tax certification form will be provided by the county office and must be signed by a county official. ❑ Any additional documents needed to establish your authority to buy/sell this home as required by ORS 446 and OAR 918 and posted at www.oregon.gov/bcd. If the home is being moved to a different county,a valid tax certification form is needed from both: ❑ (A)the county the home is moving from and (B)the county the home will be moved to ❑ If recording in or removing from county deed records, you must also submit a copy of the recorded application(Form 5176 or 5175 found at www.oregon.gov/bcd). 7 if signing by Power of Attorney, submit a Change Affidavit(Form 5221). 1f-this anuiication is being submitted by the seller, you must also submit a bill of. sale. 440-2952(7/I9/C0114) Page 5