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• DocuSign Envelope ID:7DE93942-E9D8-4605-9331-F1728F900632 1426952 NEW SECURJ'i'Y414;i4P ST HOLDERS'. - Security-interest hoarier name: Mailing address: i - Security-interest holder name: t 03 • Mailing address: g It z Buyer/new owneracknowledgement of sale%hange of ownership I affirm that the information rovided herein --� the sale/change of ownershipP accurately reflects�e ownership of the structure at the completion of I tmderstand that the home cannot be relocated without first completing the State of Oregon,Building Codes Division or one of its countyty g form and purchasing a trip Permit from I understand that the seller/owner issuagents. of Oregon,Building Codes Division oraone its for yyagents this 30 Ownership afterteclosing f the sale,and that buyers and sellers will be notified byPPlication to the State II eller/o andr fall ro wil this Owfe mail when the application is completed, I understand that, should the 46.641(1)). I tther understand that each lessorDocument m hcation within 30 days; I may complete the filing [O�ecurity-interest holder must be listed on this notice, oroifif none a c lie the maneac lien holder of rust be ane nd clear of all mortgages,deeds of trust,security interests,and liens. manufactured structure must be free Buyer/new owner name(print) 0 Right ofsurvivotship Laura Parrish ;wast signature: fPr Date: i 5/8/2021 Buyer/new owner name(print) Right of sucvivarship �` ,-. - _ _ ' (Avner signature: Date: Buyer/new owner name(print)int) Right of survivorship Buyer/new owner signature; ' Date: Buyer/new owner name(print) Right of survivorship Buyer/new owner signature: • Date: Seller/current owner acknowledgement of sale/change of ownership Application must be_aecompanied by the appropriate valid County Manufactur All owners must release their interest or acknowledge this sale/change of ownership in the form. complete this application.All current owners,including security-interestpstructure th in ordern to of ownership by signing the ownership document or DMV title or holders,he must acknowledge obw. the r ty rote es holders may elect to acknowledge the sale/change of ownership,but maintain their securityo be interest n it such time Security-interest they no longer have an interest in the home. until such time as — SetlerJcurrent owner affidavit i•aifirtn:that.I.atn the current owner of this.structure-and acknowledge that the s .refsp�onsa. e or stl.rrll•.. nonce o safe/change of ownership toAhe-State_of county agents within 30 days of the closing of the sale[ORS-446;641(1) omB g��des Division-Or—one 440-2952(7/19/COM) _ OR Title Application-1 mon-TitleApp1121 I Page 4 004446092.00001