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607101
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Last modified
6/9/2023 8:20:35 AM
Creation date
6/9/2023 8:20:34 AM
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Assessor
Account Number
607101
Assessor Doc Type
Trip Permit
MTL
093E27DD01900
Assessor Section
Manufactured Structures
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SECTION 7 NEW SECURITY INTEREST HOLDERS <br /> .:. - Security interest <br /> Cc holder Evergreen Homes Loans Phone: <br /> ' _ w Mailing Address:15405 SE 37th Street, Suite 200 . <br /> ▪ "'1 W O Y Cit Bellevue State:WA ZIP:98006 <br /> N = <br /> Email: <br /> Security interest <br /> 1 ccholder name: Phone: <br /> 0 Mailing Address: <br /> • —a • <br /> t Li O City: State: ZIP: <br /> ✓ . <br /> to i <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 Nariue:J&M Homes LLC Phone:541-928-1471 <br /> F— r- (last,first,middle) • <br /> Z I ua Email:Isimon@jandmhomes.com --. --. .- <br /> oC Z I acknowledge this sale/change of ownership, . . <br /> Ei I release my interest in this structure ❑ <br /> V O_ but 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 <br /> et : , I acknowledge this sale/change.of ownership, <br /> g. '❑ I release my interest in this structure ❑ but do not release my interest in this structure. <br /> u:.0 . .. . <br /> . Signature: Date:.,. <br /> Name: <br /> F... •rei• (last,first,middle) Phone: <br /> ww Email: <br /> cC <br /> cc 2 I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ but do not release my interest in this structure " . - <br /> V O <br /> Signature: Date: <br /> Name: <br /> - I— of (last,first,middle) Phone: <br /> w w Email: <br /> cc z <br /> cc I acknowledge this sale/change of ownership, . <br /> D ❑ I release my interest in this structure ❑V 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 clays 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,•lieui.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 <br /> Phone: <br /> F>- •• holder name: <br /> —▪ C Email: <br /> ✓ 0I acknowledge this sale/change of ownership,.. <br /> N = ❑ I release my interest in this structure ❑ but do not release my interest in this structure ' <br /> Signature: Date: . <br /> Page 4 <br />
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