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<br /> ' Security-interest holder name:
<br /> .1 NONE .
<br /> - ..
<br /> Mailing address:
<br /> ri •
<br /> . .
<br /> Security-interest holder name:
<br /> .,..," Mailing address:
<br /> a . .
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<br /> a :
<br /> .,--7
<br /> • Buyer/new owner acknowledgement of sale/Change of ownership
<br /> Ad,
<br /> [affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the
<br /> •
<br /> isale/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 /> 5.4 State of Oregon,Building Codes Division or one of its county agents.
<br /> i I understand that the seller/owner is responsible for submitting this Ownership Document Application to the State of .
<br /> - •
<br /> -16 Oregon,Building Codes Division or one of its county agents within 30 days after closing of the sale,and that all
<br /> buyers and sellers will be notified by mail when the application is completed.I understand that,should the seller/owner •
<br /> fail to tile this Ownership Document Application within 30 days,I may complete the filing[ORS 446.641(1)1 1 further
<br /> understand that each lessor,mortgagee,trust-deed beneficiary,lien holder ofrecord,and security-interest holder must
<br /> co
<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 /> . .
<br /> _
<br /> .'... Buyerhtew owner niune 0(print): Right of survivorship Buyer/new owner signature: Date: •
<br /> •
<br /> •
<br /> . .•
<br /> --------* -
<br /> b Buyer/new owner name(print): []Right of survivorship Buyer/new owner signature: Date:
<br /> -- 1 t . •
<br /> Buyer/new owner name(print): 0 Right of survivorship Buyer/new owner signature: Date:
<br /> •
<br /> •
<br /> k .
<br /> Buyer/new owner name(print): 0 Right of survivorship Btayerfnesv owner signature: Date:
<br /> • • .
<br /> . . .
<br /> .._ . :
<br /> Seller/current owner acknowledgement of sale/chenge 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 /> •
<br /> longer have an interest in the home.
<br /> Seller/current owner affidavit r 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 within 30 days of the closing of the sate[ORS 446.641(1)], •
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<br /> 44M952(7/17tCOM) Pogo 4
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