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607123
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Last modified
6/1/2023 4:06:38 PM
Creation date
6/1/2023 4:06:37 PM
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Assessor
Account Number
607123
Assessor Doc Type
Trip Permit
Doc Type Date
5/23/2023
MTL
092W33A001100
Assessor Section
Manufactured Structures
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• <br /> • <br /> SECTION 7 NEW SECURITY INTEREST HOLDERS <br /> Security interest <br /> >- holder name:Umpqua Bank Phone:888-622-9220 <br /> oc W Mailing Address:13535 SW 72nd Ave, Ste 200 <br /> w O City:Tigard State:OR ZIP:97223 <br /> Email: . <br /> Security interest <br /> > N holder name: Phone: <br /> CC LU Mailing Address: • . <br /> = J . <br /> w O . City: State: ZIP: <br /> un <br /> Email: <br /> • SECTION.B CURRENT OWNER ACKNOWLEDGEMENT <br /> All current owners (including security interest holders) must acknowledge the sale or change of ownership by signing the <br /> • ownership document,signing the DMV title,OR completing the section below.Applications missing signatures will be rejected. <br /> Legal Name:J&M Homes LLC Phone:541-928-1471 <br /> I-- (last,first,middle) <br /> 14J• W Email:lsimon@jandmhomes.com • <br /> cc Z I acknowledge this sale/change of ownership, <br /> VI release my interest in this structure Elbut do not release my interest in this structure <br /> Signature: - Date: <br /> Name: <br /> ZN (last,first,middle) Phone: <br /> w W . Email: <br /> cC Z I acknowledge this sale/change of ownership, <br /> • V O ❑ I release my interest in this structure ❑ but do not release my interest in this structure . <br /> Signature: Date: <br /> Name: <br /> t— M (last,first,middle) Phone: <br /> • • <br /> W W Email: <br /> cc Z <br /> cc I acknowledge this sale/change of ownership, <br /> • <br /> id O ❑ I release my interest in this structure ❑ but do not release my interest in this structure - - <br /> • <br /> Signature: Date: <br /> Name: <br /> Zer (last,first,middle) Phone: <br /> W W Email: <br /> CC Z I acknowledge this sale/change of ownership, <br /> GEC <br /> VO Elrelease my interest in this structure ❑ but do not release my interest in this structure <br /> Signature: Date: <br /> CURRENT OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that I am a current owner of this structure,and that I am responsible for submitting notice of sale or change of ownership to <br /> Building Codes Division or one of its county agents within 30 days of the closing of the sale per ORS 446.641(1). <br /> I further certify that I have the legal right to sell this structure,and that each lessor,mortgagee,trust-deed beneficiary,lien holder of <br /> record,and security interest holder has been listed on this notice.If none are listed,this structure is free and clear of all mortgages, <br /> deeds of trust,security interests,and liens. <br /> Security interest Phone: <br /> Fholder name: <br /> , Email: • <br /> U 0 ❑ I release my interest in this structure ❑ I acknowledge this sale/change of ownership, . <br /> N = but do not release my interest in this structure <br /> Signature: Date: • <br /> Page 4 <br />
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