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612159
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Last modified
10/1/2025 11:00:40 PM
Creation date
10/1/2025 11:58:24 AM
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Assessor
Account Number
612159
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
9/30/2025
MTL
072W07BA01000
Assessor Section
Manufactured Structures
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r <br /> Docusign Envelope ID:BBA8973C-AD5B-4531-AF00-8AF199B66FCB <br /> SECTION 7 °'`; NEW SECURITY INTEREST HOLDERS <br /> Security interest 7 <br /> Phone: <br /> holder name: <br /> W Mailing Address: <br /> _tu` 0~ City: State: ZIP: <br /> of • Email: <br /> Security interest <br /> N Phone: <br /> ,ccN" holder name: . <br /> CC*ILI Mailing Address: <br /> • J a, Q City: State: ZIP:tri <br /> W,6` <br /> Email: <br /> SECTION 8 w 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:Alta Cima CorpBA: FactoryExpo Homes Phone:503-980-3990 <br /> 1=(P (last,first, middle) p {� <br /> Lw Email:agarcia@factoryexpohomes.com <br /> •.ccm z� <br /> oC ' I acknowledge this sale/change of ownership, <br /> ❑■ I release my interest in this structure ❑ <br /> but do not release my interest in this structure <br /> uo <br /> Signature: �Q� � Date:9/29/2025 <br /> Name: <br /> t+ N (last,first, middle) Phone: <br /> Z <br /> cu uj Email: <br /> Cg <br /> .z I acknowledge this sale/change of ownership, ' <br /> �y ' ❑ I release my interest in this structure ❑ <br /> u o but do not release my interest in this structure <br /> Signature: Date: <br /> Name: Phone: <br /> M (last,first,middle) <br /> -• OCR <br /> w w Email: <br /> Cg pg Z I acknowledge this sale/change of ownership, <br /> El I release my interest in this structure ❑ but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> er (last,first,middle) Phone: <br /> G „W Email: <br /> pC Z _ I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑uo 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 /> Phone: <br /> holder name: <br /> cd Email: <br /> , I acknowledge this sale/change of ownership, <br /> u O ❑ I release my interest in this structure ❑ <br /> W;r T but do not release my interest in this structure <br /> Signature: Date: <br /> Page 4 <br />
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