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' . 1 rfiurtfLer certify that each lessor, mortgagee, holder has been listed on this notice,or none are listed,that this trust-deed beneficiary,lien holder•of record, and security interest deeds of is st, security ted interest,and ralss and structure is free and clear of that I have the legal right to sell this . all mortgages, Se�er/ct�rreat owner manufactured structure, re(print!. Seller/ztat;ret2t own ignature: houe:3 J r f 7 =arz: Date: -Email: U o ICPAt\ I tA- r I release my interest in this sett ooze. elletletjt're owner ❑ ! ktoitledgctitis uIc/chcngeofownership, 1 name(print): Seller/current i'8I1 owner signature: but do not release my Interest in the savrau. SDate: ❑ Phone: I release my interest in this structure Email: j ff ' ❑ i ac'mowledge this sdlelchange of ownership, Seller/current ft?.;'t2e but do not release name(prittlj: �Btlei'/CL� my interest in the structure. e re&t owner signature: Late: I Furore: I release my interest in this sanctum. Email: t 1 aclmotvtedge this sale/change of ownership,but do not release my interest in the (pita): Seller/current ownsignatt,re: '3aLe. ❑ structure. �el�Er:/C� t7t owner'name Phone: release my interest in this structure.out onot release mylinterest noihets:ructure. f SECURITY INTEREST HOLDER ALREADY Onl RECO.Rt (if aPp/Ic b S` rIty toider's,ante(prirrrj: 5ecutity ho3 ��) de signature: Late: ri I �.�J1 f[2.'ease n-i)•;nterest in this structure. 1 ❑ tore. Security toj�r' o r I ncknowl tte this sale/horse Drew-me:ship, I s name(strut): 1 �'°CUr1Ly'le0lf�el''g Sig " r.o• ❑ but do not release I � a�• Date: ease m-interest in the stracr I release m.interest in this s7ttcritra. I ri1 acknowledge this sale/char a of ownet;hi l t; i �%I ' "a- r out donot re g i lW _ :NG, CHECK' THE 't LLOV 14�i e ease m intere in the sertrcture Signatures from all applicable parties must be complete (current owners/seller in :esu molders). s, sew owners/buyers,and security Q A valid#ax certification from the county tax assessor.The tan certification office and must be sued by a count- cation form j ofricial, will be provided by the county ❑� Amy additional documents needed to establish your authority to buy/sell 1 and OAR 918 and posted at www.oregon.gov/bcd.home ,on.gov/bcd. Y sell fulls home as required by O� 446 I 0 is beim aT � Tit e county o moved to a different county, a valid tax certification form is needed (B) the county therHome�, moving from and ill be moved to fiotn �` ; ' D If recording in or removing from county deed records,you must also submit a co application (Form 5176 or 5175 found at CIIf si signing Power of Attorney in bywww.oregon.gozr/bcd) copy of the recorded IPthis a l , submit a Change Affidavit (Form 52 pp ication is being submitted by the seller; 2l). you must also submit a bill of sale. 40-2952(7n 7/COM) Page S 5'd 66Z 1.-.00Z-£09eoinfag autoH a igow s6no4 e8�:L L 'OZ 9Z qed