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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(print): Seller/current owner signature: Date: fi I release my interest in this structure.
<br /> HOMES DIRECT OF OR r 10/5/2018
<br /> Phone' 541-928-2083 ❑ I acknowledge this sale/change of ownership,
<br /> but do not release my interest in the structure.
<br /> Email: neilaw31@gmail.com
<br /> Seller/current owner name(print): Seller/current o ncr signature: Date: ❑ I release my interest in this structure.
<br /> •
<br /> I acknowledge this sale/change of ownership,
<br /> Phone: ❑ but do not release my interest in the structure.
<br /> Email:
<br /> Seller/current owner name(print): Seller/current owner signature: Date: ❑ I release my interest in this structure.
<br /> I acknowledge this sale/change of ownership,
<br /> Phone: ❑ but do not release my interest in the structure.
<br /> Email:
<br /> Seller:/current owner rranre(print): Seller/current owner signature: Date: ❑ I release my interest in this structure.
<br /> I acknowledge this sale/change of ownership,
<br /> Phone: ❑ but do not release my interest in the structure.
<br /> Email:
<br /> •i h t ° - 2 ;.te ,rc�„'n1. G3�. :a:p, v"?v baa?? .�,C.c;:1 x ..: `�,. r :. �. .. v }t Sj;
<br /> ��, , ,r ' SECURITY NTERES HOLDER Qt R ADY O RSRECORD applicable, s� rt
<br /> th � � lay �r �x + t z. � r i g-,.x.tu,f-. .� h �
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<br /> Security holder's name(print):
<br /> Security holder''s"signature: Date: El release mny interest in this structure.
<br /> ❑ 1 acknowledge this sale/change of ownership,
<br /> but do not release my interest in the structure.
<br /> Security holder's name(print):
<br /> Security holder's signature: Date: ❑ I release my interest in this`structure.
<br /> ❑
<br /> I acknowledge this sale/change of ownership,
<br /> but do not release my interest in the structure.
<br /> u,.: z4�` t'�« ` - '�,u±lr�r •* .S .. .�. rn•, ,
<br /> ki e"4 YT t Ai t 1 -°4•PRIOR TO SUBIVV�ITTING CHECK THE FOLLOVIIINGi, " Mfr, ? x
<br /> t s Lr CX:. ,...„. r ., r 5 - .�s,/, i5,r.,i: .4 ``.u+.�<..x Y., ,.P.1,./ x�c:}.' f ” t..
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<br /> ❑ Signatures from all applicable parties must be complete(current owners/sellers, new owners/buyers,and security
<br /> interest holders).
<br /> ❑ A valid tax certification from the county tax assessor.The tax certification form will be provided by the county
<br /> office and must be signed by a county official.
<br /> ❑ 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 /> ❑ (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.gov/bcd)
<br /> ❑ If signing by Power of Attorney, submit a Change Affidavit(Form 5221).
<br /> ❑ If this application is being submitted by the seller, you must also submit a bill of sale.
<br /> 440-2952(7/17/COM) Page 5
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