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SECTION 7 NEW SECURITY INTEREST HOLDERS Security interest ' holder name: r Phone: = 0 Mailing Address: J - U O City: State: ZIP: to Email: Security interest IN holder name: Phone: W Mailing Address: • J W O City: State: ZIP: tn = Email: SECTION 8 CURRENT OWNER ACKNOWLEDGEMENT All current owners (including security interest holders) must acknowledge the sale or change of ownership by signing the - ownership document,signing the DMV title,OR completing the section below.Applications missing signatures will be rejected. Legal Name: &M Homes LLC Phone:541-928-1471 (last,first,middle) wW Email:Isimon@jandmhomes.com z I acknowledge this sale/change of ownership, II] I release my interest in this structure ❑ u• O but do not release my interest in this structure Signature: Date: Name: ZN (last,first,middle) Phone: "Iw Email: �..Z I acknowledge this sale/change of ownership, U O 0 I release my interest in this structure ❑ but do not release my interest in this structure Signature: Date: Name: F— m (last,first,middle) Phone: iu W Email: C I acknowledge this sale/change of ownership, ❑ I release my interest in this structure ❑ but do not release my interest in this structure u O Signature: Date: - Name: I— et (last,first,middle) Phone: _ Z U W Email: CC Z I acknowledge this sale/change of ownership, 0 I release my interest in this structure ❑ but do not release my interest in this structure u O Signature: Date: • CURRENT OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP __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 Building Codes Division or one of its county agents within 30 days of the closing of the sale per ORS 446.641(1). I further certify that I have the legal right to sell this structure,and that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security interest holder has been listed on this notice.If none are listed,this structure is free and clear of all mortgages, deeds of trust,security interests,and liens. Security interest Phone: >- holder name: W Email: CC CZ U 0 I acknowledge this sale/change of ownership, N = ❑ I release my interest in this structure ❑ but do not release my interest in this structure Signature: Date: Page 4 -