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322115
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Last modified
1/13/2022 5:59:47 AM
Creation date
12/8/2017 3:27:05 PM
Metadata
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Template:
Assessor
Account Number
322115
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
12/7/2017
MTL
052W17A000300
Assessor Section
Manufactured Structures
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• NEW SECURITY-INTEREST HOLDERS <br /> 4, Security-interest holder name: <br /> L. <br /> -so. Mailing address: <br /> Security-interest holder name: <br /> al Mailing address: <br /> u <br /> d <br /> Buyer/new owner acknowledgement of sale/change of ownership <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the <br /> .▪ sale/change of ownership. <br /> I understand that the home cannot be relocated without first completing this form and purchasing a trip permit from the <br /> State of Oregon,Building Codes Division or one of its county agents. <br /> EI understand that the seller/owner is responsible for submitting this Ownership Document Application to the State of <br /> 3 Oregon,Building Codes Division or one of its county agents within 30 days after closing of the sale,and that all <br /> .bpyers and sellers will be notified by mail when the application is completed.I understand that,should the seller/owner <br /> fail to file this Ownership Document Application within 30 days,I may complete the filing[ORS 446.641(1)].I further <br /> understand that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security-interest holder must <br /> be listed on this notice,or,if none are listed,the manufactured structure must be free and clear of all mortgages,deeds <br /> of trust,security interests,and liens. <br /> Buyer/new owner name(print): D Right of survivorship Buyer/new owner signature: Date: <br /> Coleman Real Estate Group, LLC /W it liqb7 <br /> CA Buyer/new owner name(print): D Right of survivorship Buyeer/neew owner signature: Date: <br /> d <br /> Buyer/new owner name(print): D Right of survivorship Buyer/new owner signature: Date: <br /> Psi <br /> Buyer/new owner name(print): D Right of survivorship Buyer/new owner signature: Date: <br /> Seller/current owner acknowledgement of sale/change of ownership <br /> Application must be accompanied by the appropriate valid County Manufactured Home Notification form. <br /> All owners must release their Interest or acknowledge this sale/change of ownership in the structure In order to <br /> complete this application.All current owners,including security-interest holders,must acknowledge the sale/change of <br /> ownership by signing the ownership document or DMV title or completing the section below.Security-interest holders <br /> may elect to acknowledge the sale/change of ownership,but maintain their security interest until such time as they no <br /> longer have an interest in the home. <br /> Seller/current owner affidavit I affirm that I am the current owner of this structure and acknowledge that the seller is <br /> responsible for submitting notice of sale/change of ownership to the State of Oregon Building Codes Division or one of • <br /> its county agents withih 30 days of the closing of the sale[ORS 446.641(1)]. <br /> 440-2952(7/17/COM) Page 4 • <br />
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