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I further certify that each lessor,mortgagee,trust-deed beneficiary, lien holder of record,and security-interest
<br /> holder has been listed on this notice,or if none are listed,that this structure is free and clear of all mortgages,
<br /> deeds of trust,security interests,and liens and that I have the legal right to sell this manufactured structure.
<br /> Seller/current owner name(prim): Seller/current owner signature: Date: _ ® T release my interest in this gruoture.
<br /> CASCADE FACTORY
<br /> Phan;; 503 881-5314 ❑ Iacknowledge this sale/changaofownership,
<br /> ( ) but do not release my Interest in the structure.
<br /> Entail: CASCADE;HOMESt YAis
<br /> Seller/current owner mune(print): Seller/current owner signature: ,Date: I release My interest in this sunoture,
<br /> Phone: acknowledge Ibis aalelclsange a outlets*,but do not release my interest in the stntuturr,
<br /> Email: •
<br /> Sellerleurt'ent owner name(print): Seller/Current airner signature: Date: E la m my interest in this*mature.
<br /> Phone: Iauknowledga this saleiehangeafownership,
<br /> but do not release my bltem,t to the immure.
<br /> Emil:
<br /> Seller:/current owner nameOrtnt): , Seller/current owneraigmttturet Date: [] irelease myinterest inthis atntoture.
<br /> IAcknowledge this ealrJ�unigeoremus p,
<br /> Phone: but do not release toy Interest In the*nonce.
<br /> Entail
<br /> _.:.N'•�.i.:Y.�"y4.,�Y.�s7lri:41;i6.t..`f^s S xc. k1,..•y. . ?•L:'•s• ..ti�h, . h• 0�1• • .. ...:. e. . ... 7_
<br /> '
<br /> ,dA 4l'
<br /> Security holder's name(print): Security holder's signature; Date: Q Irelease ms
<br /> yintereinthis stn,cwre.
<br /> DI ecknuwlcdge this anklehsnge of ownership,
<br /> Inn do not release my interest is the sWetum.
<br /> Seenritybolder's name(plfirt):
<br /> Security holder's signature; Date: fl Irelsase my interest in this Mehra.
<br /> I acknowledge This salafehtmgs of ownership,
<br /> 1-1 but do not re base m lomat in the structure.
<br /> �, �• .1, _ ..,,, ., 1.,•. r ..P. :.•�r:•ati.i•i •-,C> ' �t +.i F��i;,i
<br /> :��'s.73::ty7�"'E:_v i,, ,:c_• •�'-�- t_?1�b 61iJ�� 4��� .lel ` .:3` •�:;:' :., r. c
<br /> .. :4.��,'r..i�t��":?I:;:•;;.: . _.. •�;S�I �h ��:'.r. .;�...ISR�11�1 :'...4`
<br /> i Signatures from all applicable parties must be complete(current owners/setters,now owners/buyers,and security
<br /> interest holders).
<br /> ri A valid tax certification from tate county tax.assessor. The tax certification form will be provided by the county
<br /> office and must be signed by a county official.
<br /> ri Any additional documents needed to establish your authority to buy/sell this home as required by ORS 446
<br /> and OAR 918 and posted at www_oregon.gov/bcd.
<br /> If the home is being moved to a different county,a valid tax certification form is needed from both:
<br /> 0 (A)the county the home is moving from and
<br /> (B)the county the home will be moved to
<br /> • If recording in or removing from county.deed records,you must also submit a copy of the recorded
<br /> application (Form 5176 or 5175 found at www.oregon,gcv/bod)
<br /> © If signing by Power of Attorney,submit a Change Affidavit(Form 5221), s
<br /> �] If this application is being submitted by the seller,you must also submit a bill of sale.
<br /> •
<br /> 440-2952(7t17'COM? Page 5
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