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• <br /> Clackamas County Official Records 2023-0280'89 <br /> Catherine McMullen, County Clerk <br /> After recording return to: S 7 7L/? <>• <br /> A)cwie7�l5 ',' ;e R , ptoiall4\ i 1111111111 II 1111111 I111111111111 liii • $93:00 <br /> cii���.› - ? JJII? .. aiv <br /> 02636198202300280890010015 08/07/2023 03:07:12 PM <br /> Send all future tax bills to: . 1.1Yle . _ .. _ <br /> D-MHEW Cnt=1 Stn=2 COUNTER3 <br /> $5.00$16.00$62.00$10,00 <br /> APPLICATION TO REMOVE . <br /> MANUFACTURED.HOME FROM <br /> COUNTY DEED RECORDS . . - - <br /> .:!YEAR - ftIAKE MUD NUMBER VIN/SERIAL NUMBER WIDTH ,LENGTH <br /> 1998 . - MARLETTE H015161AB 28' - 48'. . <br /> HOME ID,NUMBER RECORDERS DOCUMENT NUMBER MAP&TAX LOT NUMBER <br /> X045751 98-049473 61E10 01600 <br /> LEGAL DESCRIPTION: <br /> (liaise list the legal description of the land upon which the structure is located in the space below.This may either be a copy of the deed or a description of the <br /> Property as recorded in the county deed records:(Attach additional sheets. if needed) <br /> SEE DEED REFERENCE NUMBER 2019-010620 <br /> It there is a secured interest in the property(land and manufactured structure).list the names and addresses of all security interest holders,mortgagees.trust deed <br /> beneficiaries,or lien holders of record holding any interest in the land and manufactured structure in the spaces below.All secured parties must sign and approve <br /> (hit form.If there arc more than two secured panics,provide the names and addresses and approval signatures on a separate sheet of paper and attach to this form. If <br /> there are none.write"none" <br /> *t`17\VL certify that the statements made on this application are true to the best of my/our knowledge.All mortgagees,trust deed beneficiaries,lien holders of <br /> record and security interest holders are listed.or if there are none,I have certified this by writing"none"in the space provided. ' `-. ." <br /> OWNER INFORMATION:. <br /> PRTErt N at OFOWNERIS� ( <br /> � I t )) tic. . <br /> .._. <br /> 51GNA'rURF.o&AS4NeR`'�'_._ • _ `� SrrUS ADDRESS ") -;"m f ti ft�, <br /> _�� - V77(-(5' 5 ,A/ t.,)to .ti D5-- r-- 703 <br /> �.-- OR- 9 ry <br /> SIGNATURE OF OWNFIR/o-----^"' MAILING ADDRESS 1 <br /> SECURED('ARTY INFORMATION: <br /> NAME OF SECURED PARTY <br /> ADDRESS OF SECURED PARTY - <br /> SIGNATURE/APPROVAL OF SECURED PARTY. <br /> *Owner and Secured party signatures must be notarized. Attach additional sheets if necessary. <br /> NOTARY: �J�� <br /> State of Oregon County of G a,G(s.arri✓'t.�-' <br /> Tl�je,,fore oing instrument was a,c, nowledged befor me is ��1 day of I' i OFFICIAL STAMP <br /> rc r.. <br /> ( j4_r ,2023 by Y 1 1l l D C DIEDR�+C CHRISTENSSAi <br /> ���,, �� NOTARY PUBLIC-OREGON <br /> `'ic COMMISSION NO.1029788 <br /> Signature of Notary Public ._..... MY COMMISSION WIRES OCTOBER 16,2026 <br /> My commission expires: �O f( �k <br /> Itt�DEPARTMcN f Of" This certification is being submitted for recording to the county clerk for the county in which the real property is located. <br /> r CONSUMER A copy of said recorded document is being provided to the State of Oregon Building Codes Division or one of its county <br /> - 1)614 USINESS <br /> SERVICES agents,along with the County Manufactured Home Notification and Tax Certification Form for Used Homes and a <br /> 440-5175(I!17/COM) Manufactured Home Bill of Sale/Change Application. <br /> 1 <br />