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DocuSlgn Envelope ID:34F982E3-3576-46E2 ``13-6F5419FB55F0 1638344 SECTION.r= `: -:NEW'SECURITY INTEREST{HOLDERs t : .4k ,' Sccunty;r teres< holder name: I Phone: rei,W;.Mailing Address:. City; -. State,.: .. ZIP:.. z Email: Security interest "+ holder name: 1 Phone: Mailing Address: "• City:. . . LW t�; -- ( starts: ( z>P: ;,,c0.!X. Email: SECTION S _` CURRENT OWNER ACiCNOWLEDGEMLsNfi y 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: ,++ ,�f h )j ,+ r (last f+rSG middle) ICU 1 1 I 1 1�` I Phones/I"(/ ;- - i itlk Email: 1 I release my interest in tills structure r I acknowledge this sale/change of ownership, , but do not release my interest in this structure Signature: 0 1 At Date: Z V(� Legal Name: V �� ! l l.. N. past,first middle) Phone: W.'tY Email: le. LU �`,z' I release my interest in this structure r I acknowledge this sale/change of ownership, a, but do not release my interest in this structure U ® _ Signature: Date: Legal Name: F. col {last,first,middle) Phone: W Ce Email: f e 0 r I release my interest in this structure r I acknowledge this sale/change of ownership, but do not release my interest in this structure Signature: Date: Legal Nanie: F— d, (last,first,middle) Phone: W W • Email: CZ = Zr I release my interest in this structure r I acknowledge this sale/change of ownership,nterest in dais.structure ® but do not release my i Signature: I 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 dosing 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 VANDERBILT MORTGAGE AND FINANCE,INC. Phone: ��.. holder name: I WEmail: Ce A - V:--1, [ I release my interest in this structure [ I acknowledge this sale/change of ownership, W but do not release my interest in this structure Signature: I Date: I 440-2952(1.1l22/BCD) Page 4 Olt Title Application-7/2023-TitleApp11211 004766514-00006