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612029
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Last modified
6/25/2025 11:08:14 PM
Creation date
6/25/2025 2:07:07 PM
Metadata
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Template:
Assessor
Account Number
612029
535515
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
6/24/2025
MTL
092W22D001800
Assessor Section
Manufactured Structures
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SECTION 7 NEW SECURITY INTEREST HOLDERS <br /> Security interest <br /> holder name: Phone: <br /> pC:: ".. • .. .._._ . <br /> ce w Mailing Address: <br /> - <br /> U City.: State: ZIP: <br /> Email: <br /> Security interest - <br /> holder name: Phone: <br /> 2:w Mailing Address: <br /> State: ZIP: .. <br /> -; Email: <br /> SECTION 8 := CURRENT OWNER.ACKNOWLEDGEMENT <br /> All current owners (including security interest holders) must acknowledge the sale or change of ownership by signing the <br /> ownership document,signing the DMV title,OR completing the section below.Applications missing signatures.will be.rejected. <br /> Legal Name:J&M Homes LLC Phone:541-928-1471 <br /> (last,first,middle) <br /> w W Email:Isimon@jandmhomes.com _ _ <br /> -tC Z I acknowledge this sale/change of ownership,• <br /> El I release my interest in this structure ❑ <br /> but.do not release my interest in this:structure <br /> Signature: • Date <br /> Name: <br /> N = (last,first,middle) Phone: _. <br /> mi.' <br /> w Email: <br /> ❑ I release my interest in this structure LiI acknowledge this sale/change of ownership <br /> but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> 1. 0,1 ' (last,first,middle) Phone: <br /> Email: <br /> awe z I acknowledge this sale/change of ownership, <br /> I release my interest in this structure ❑ but do not release my interest in this structure <br /> v <br /> Signature: • Dater <br /> Name: <br /> - (last,first,middle)= Phone: <br /> Email: <br /> •OCZ° <br /> -cc: I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ but do not release my interest in this structure <br /> U:.o <br /> Signature: Date: <br /> CURRENT OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that I'am a currentowner of this structure,and that I am responsible for submitting notice of sale or change of ownership to <br /> Building Codes Division or one of its county agents within 30 days of the closing of the sale per ORS 446.641(1). <br /> I further certify that I have the legal right to sell this structure,and that each lessor,mortgagee,trust-deed beneficiary,lien holder of <br /> record,and security interest holder has been listed on this notice.If none are listed,this structure is free and clear of all mortgages, <br /> deeds of trust,security interests,and liens. <br /> Security interest Phone: <br /> Fholder name: <br /> w Email: . <br /> I acknowledge this sale/change of ownership, <br /> U. O ❑ I release my interest in this structure ❑ <br /> LLI2 but do not release my interest in this structure <br /> Signature:. Date: <br /> Page 4 <br />
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