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DocuSign Envelope ID:OF1E7DA7-A1D5-430B-9D1"—cAF4F213CFB NEW SECURITY-INTEREST HOLDERS Security-interest holder name: 51 _` )C'Wit}t, l& \\SA< _ • I'l filing address: ,t1 PC: CX cr 7 C`D C" z i �i '1 L_L`r f."LA.NJL`.C..1 W A ()„C 3'(.r ...-.4 Security-interest holder name; . Mailing address: L Y Buyer/new owner acknowledgement of sale/change of ownership 1. ' I an that the i 4. ffinformation provided herein acetiratelreflects the a nership of the structure at the eompletiun ''1lht' sale<ehange c,lowncrship, understand that the holm cannot he relocated ssithout first completing'this firm and purchasing a trip permit ti-o m the State of Oregon. Rui[ding(-'odes Di%ision or one of its count\ agents. CE gi I understand that the seller•utt ner is responsible lir submitting this Ownership Document Application to the State of w Oregon.Building Codes Division or one of its county agents within 30 days after closing of die sale.and that all buyers and sellers will he notified by mail warn the application is completed. i understand that,should the seller of+act 9, tail to file this Ownership Document Application a ithin 30 days. i may complete the tiling[ORS•1 ih.h I it i t). I further understand that each lessor. tnortga ee. trust-deed henc'tieiary. lien holder of record.and security-interest holder : t be hsteU on this notice,or. if none are listed. the manufactured stricture niusl be free and cleaner all mortgaves.spec' of trust,security interests,and liens. Buyer/newt».ncr munetpr/nil: ❑ Right of'stir\I\oi ltip Bines/new owner signature: Date: w-aw�wer: :7J 5.1 C Kevin Becker i ¢ 6i1,6& kt,r Buyer/new owner name)/aunt: ❑ Right Lir sun is unship Buyer/nest owner signature: Date: Jeanne Becker 0pe"9�'db" / �� s ,Cs ono 3aG4$ 3/1/51-D Buyer/new owner name(/nvnrh: 0 Right of stirs i otship Buyer/new owner signature: Date: Buyer/new owner name(print): ❑Right of sues korship I Buyer/new owner signature: ` Date: Seller/current owner acknowledgement of sale/change of ownership Application must he accompanied the appropriate talid County Manufactured I tone Notification ferns. All owners must release their interest or acknowledge this sale/change of ownership in the structure in order to complete this'application.All current owners. includin4 security-interest holders, must acknowledge the saleehange t11111e1Ship h. signing the ownership document or DMV title or completing the section below, Security-interest holders oat elect to aeknossledge the sale'ehange of'osinetship. but maintain their security interest until such time as ihet rn longer hale an interest in the Thome. Seller/current owner affidavit I at'tirm that 1 am the current ismer of this,structure and ackmi ledge that the seller is responsible for sobutittin notice of sale'rhange of'ot+nership to the Slate of(il'egon Building Codes Division or one of its county agents t1 ithin itl da s tai the closing ol'the sale IORS 446.64 h i i -_ _ •r,, WO) Page 4