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• <br /> NEW SECURITY-INTEREST HOLDERS <br /> Security-interest holder name: <br /> 1. Mailing address: • <br /> u <br /> as <br /> • <br /> Security-interest holder name: • <br /> • <br /> es <br /> Mailing address: <br /> U <br /> d <br /> cn <br /> , Buyer/new owner acknowledgement of sale/change of ownership <br /> _. I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the <br /> sale/change of ownership. <br /> b <br /> rI understand that the home cannot be relocated without first completing this form and purchasing a trip permit from the <br /> State of Oregon,Building Codes Division or one of its county agents: <br /> c I understand that the seller/owner is responsible for submitting this Ownership Document Application to'the State of <br /> Oregon,Building Codes Division or one of its county agents within 30 days after closing of the sale, and that all <br /> G buyers and sellers will be notified by mail when the application is completed.I understand that,should the seller/owner <br /> a, fail to file this Ownership Document Application within 30 days,I may complete the filing[ORS 446.641(1)].I further <br /> understand that each lessor,mortgagee, trust-deed beneficiary,lien holder of record,and security-interest holder must <br /> be listed on this notice, or, if none are listed,the manufactured structure must be free and clear of all mortgages,deeds <br /> • of trust,security interests,and liens. <br /> Buyer/new owner <br /> name(print): ri Right of survivorship Buyer/new owner signature: Date: <br /> lel Buyer/new owner name(print): ❑Right of survivorship Buyer/new owner signature: Date: <br /> Buyer/new owner name(print): 0 Right of survivorship Buyer/new owner signature: Date: <br /> tl <br /> Buyer/new owner name(print): 0 Right of survivorship Buyer/new owner signature: Date: <br /> Seller/current owner acknowledgement of sale/change of ownership <br /> Application must be'accompanied by the appropriate valid County Manufactured Home Notification form. <br /> All owners must release their interest or acknowledge this sale/change of ownership in the structure in order to • <br /> complete this application.All current owners, including security-interest holders,must acknowledge the sale/change of <br /> ownership by signing the ownership document or DMV title or completing the section below. Security-interest holders <br /> may elect to acknowledge the sale/change of ownership, but maintain their security interest until such time as they no <br /> longer have an interest in the home. <br /> Seller/current owner affidavit <br /> I affirm that I am the current owner of this structure and acknowledge that the seller is responsible for submitting notice • <br /> of sale/change of ownership to the State of Oregon Building Codes Division or one of its county agents within 30 clays of <br /> the closing of the sale [ORS 446.641(1)]. <br /> 440-2952(.7/19/COM) Page 4 <br />