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606898
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Last modified
6/2/2023 8:58:07 AM
Creation date
6/2/2023 8:35:39 AM
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Assessor
Account Number
606898
Assessor Doc Type
Trip Permit
Doc Type Date
5/31/2023
MTL
105E02AD10200
Assessor Section
Manufactured Structures
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• <br /> • <br /> • <br /> SECTION 7 NEW SECURITY INTEREST HOLDERS <br /> Security interest <br /> ›-- holder name: Phone: <br /> = 0 Mailing Address: <br /> "� City: State: ZIP: <br /> W O <br /> tr) <br /> Email: <br /> • Security interest <br /> holder name: Phone: <br /> cz <br /> • <br /> = 0 • Mailing Address: <br /> City:W O State: ZIP: <br /> t.n <br /> Email: <br /> SECTION 8 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 /> aEmail:Isimon@jandmhomes.com <br /> lY z I acknowledge this sale/change of ownership, <br /> ❑■ I release my interest in this structure ❑ <br /> U O but do not release my interest in this structure <br /> Signature: • Date: <br /> Name: <br /> I- N (last,first,middle) Phone: <br /> ww Email: <br /> cc cC <br /> Z I acknowledge this sale/change of ownership, <br /> D El I release my interest in this structure ❑ <br /> U O but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> Zr (last,first,middle) Phone: <br /> w Email: . <br /> OTC I acknowledge this sale/change of ownership, <br /> C.) O I release my interest in this structure ❑ but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> I- d (last,first,middle) Phone: <br /> U./ u Email: <br /> cC <br /> oC I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ <br /> U O 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 /> pC holder name: <br /> I— <br /> CY 0 Email: • <br /> V JO I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ <br /> Nbut do not release my interest in this structure <br /> Signature: Date: • , <br /> • <br /> Page 4 • <br />
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