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612406
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Last modified
9/11/2025 11:01:42 PM
Creation date
9/11/2025 9:27:44 AM
Metadata
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Template:
Assessor
Account Number
612406
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
9/10/2025
MTL
091W19BB03300
Assessor Section
Manufactured Structures
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Docusign Envelope ID:23419788-209B-4385-86DA-B6B161E1AFAB <br /> IOu40J1 <br /> SECTION 7 .. <br /> NEW SECURITY INTERES s .4OLDERS i <br /> �, Security interest — <br /> F re holder name: Phone: <br /> = Q Mailing Address: <br /> W ®.-IICity: _ State: � ZIP: <br /> 60 2 Email: <br /> N Security interest <br /> holder name: Phone: <br /> le <br /> ® Mailing Address: • <br /> W ® City: State: ZIP: <br /> U31 Y 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: t a <br /> r (last,first middle) i 4 '0—) k Phone:C,'}�1_ ---) _ cr- <br /> W W Email: r I 1 <br /> Ir <br /> zrcil r-I release my interest in this structure n I acknowledge this sale/change of ownership, <br /> C.) 0 Doaugt"ed by: but do not release my interest in this structure <br /> Signature: Wettitt iteOff Date:1/9/2025 <br /> Legal Name:\ MI ERAtltd•1.0.44 r.. <br /> (- 4N (last,first,middle) Phone: <br /> ILL W Email: I <br /> ' Z [ I release my interest in this structure D,_. . I acknowledge this sale/change of ownership, <br /> 00 <br /> but do not release my interest in this structure <br /> Signature: Date: <br /> Legal Name: <br /> F.- en (last,first,middle) Phone: <br /> W W Email: <br /> re cg 0 [ I release my interest in this structure ❑ I acknowledge this sale/change of ownership, <br /> but do not release my interest in this structure <br /> Signature: I Date: <br /> Legal Name: <br /> Z43. (last first,middle) - Phone: <br /> Lll X Email: <br /> Et ILI <br /> 2 [ I release my interest in this structure n I acknowledge this sale/change of ownership, <br /> L.) 0 <br /> but do not release my interest in this structure <br /> Signature: Date: <br /> CURRENT OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> 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 <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 <br /> re <br /> holder name: Phone: <br /> M el Email: <br /> M -t [ I release my interest in this structure I: I acknowledge this sale/change of ownership, <br /> but do not release my interest in this structure <br /> CO <br /> Signature: I Date: <br /> 440-2952(11/22BCD) Page 4 <br /> OR Title Application-9/2024-TitleApp11211 004966077-00002 <br />
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