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Requested By:4 pages 134335 or 141080 08/29/2024 —"-"- <br /> - REEL PAGE <br /> 1323 726 <br /> * r)I\-I V° APPLICATION TO EXEMPT A MANUFACTURED STR.uC <br /> T0g •°" FROM REGISTRATION AND TITLING K E�E D <br /> des <br /> ices LA"AAVE,it Mal°W-314. X I Ow <br /> ner's wner's Certificate ofLegal Interest <br /> t.� '73 Y o� J U N 2 7 1996 <br /> 0 INSTRUCTIONS: �� <br /> Complete all sections. This form must be signed by all Interest-holding parties and have a Title Report or Lot Bolo ValpiachDe ION <br /> N. <br /> which cannot be over 7 days old when submitted to DMV. <br /> FThis form and Title Report or Lot Book Report must be submitted with your manufactured structure ownership documents and,if the <br /> 00 . manufactured structure Is to be financed by a third party,proof of a loan approval. <br /> I'AH I i <br /> Legal description and location of real property which is(description as recorded by county recorder or a certified copy of your deed may be <br /> substituted): See Exhibit "A" Attached hereto <br /> aka: 6178 Aspen Way Northeast, Salem, OR 97301 <br /> If there is a mortgage,deed of trust or lien on this land list all mortgagees and beneficiaries of deeds of trust below.Space is provided for <br /> two names and addresses. If there are none,write"none". <br /> NAME AND ADDRESS _ --"— <br /> Cub Funding Corporation, 10260 SW Greenburg Rd, Ste 535, Portland, OR 97223 <br /> NAME AND ADDRESS <br /> i <br /> I <br /> Tax Lot Number(from assessor): 52009-527 <br /> PART ll <br /> Legal description of the manufactured structure which Is located on the real property described above: ' <br /> YEAR MAKE WIDTH "LENGTH � VEHICLE IDENTIFICATION NO. <br /> 1968 ELCAR .Z. 1 y4 ED20572CRM9429 <br /> ..List all security interest holders,mortgagees,beneficiaries of deeds of trust,and lenholders whose Interest is secured by the manufactured. <br /> `structure described above.Space is provided for two names,addresses and approvals.Signatures from the parties listed below are their <br /> approval that the application may be submitted. if there are none,write"none". <br /> NAME AND ADDRESS <br /> Cub Funding Corporation, 10260 SW Greenburg Rd, Ste 535, Portland, OR 97223 <br /> NAME AND ADDRESS <br /> SIG►( TUREOFSECURED_P�R 61163(1Y1 E-{q�GLO SytGNATUREOF SECURED PARTY DATE <br /> Tax Lot Number(from assessor). •00147342 <br /> ® Me do not know the whereabouts of the permanent plate assigned to this vehicle. <br /> I/We certify that the statements made above are accurate to the best of my/our knowledge. All liens, deeds of trust, mortgages and <br /> security interests have been listed. If there are none,I/We have certified this by writing"none'in the space provided. <br /> PRINTED NAME OF OWNER(S) <br /> Michael J. Wall and Shelley M. Wall <br /> SIGNATURE OF OWNER ADDRESS TELEPHONE(Optioned) <br /> 6178 Aspen Way Northeast, Salem, OR 97301 <br /> 81 ATUREOFOWNER ADDRESS <br /> X5 m. LA) 6178 Aspen Way Northeast, Salem, OR 97301 <br /> V OFFICE USE ONLY ' PART III V• OFFICE USE ONLY V <br /> I <br /> I <br /> Application for exemption for a manufactured structure is hereby approved. (.O.d <br /> DATE q SIGNATURE OF DMV OFF - <br /> This exemption Is VOID If not recorded with the county within 15 calendar days from: ,4 !v/0�Z <br /> 735•6722(10.93) SEE REVERSE FOR COUNTY RECORDING AREA (STK n 30035 <br />