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359522
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359522
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Last modified
10/21/2021 9:01:05 AM
Creation date
6/30/2020 4:14:45 PM
Metadata
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Template:
Assessor
Account Number
359522
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
6/23/2020
MTL
041W17CA01301
Assessor Section
Manufactured Structures
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DocuSign Envelope ID:65E51 FEO-B5FO-4936-9834-B32EE55D8219 <br /> 'AM.,d.5eP11 C3F rad is 4Ci 1.440 Rte" i,i' -r1`.:�7?+p�- !�t 3,td1„h.+('+'�,..ri"kT' ;l i 4A ld,�...t^Y;ti�r {Vr`p.!%.la,+=r'�.:'+;1i'i...sT fialU �s rS��"v„Y- ..i�}Cd: .reP4J�..�i, ,�z:3/4 <br /> 0,04,W tii ,.ff.O Std t tV9,4. v'�`�C,1:l' :4 NTERESI`ii01.DERS -o444 l . 'd f _ <br /> +r - l <br /> Security-interest holder name: <br /> Mailing address: <br /> rd <br /> :^l <br /> U <br /> Security-interest holder name: <br /> cts. • <br /> Mailing address: <br /> iL <br /> Ad- <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 /> •b. 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 /> _c: I understand that.the sell.er/owner is responsible for submitting this Ownership Document Application to the State of <br /> 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 file this Ownership Document Application within 30 days, [may complete the filing[ORS 446.641(1)]. I further <br /> :61:. '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): XRight of survivorship Buyer/new owner signature: Date: <br /> �DocuSignedby: <br /> Steven Brian Morris <br /> AuntYS 6/8/2020 I 2:25 PM PDT <br /> adBuyer/new owner name(print): XRight of survivorship '13W6V.h �`�6irer signature: Date: <br /> : cu igne by. <br /> Lauri Lyn Morris bmoi (kolviS 6/8/2020 i 2:27, PM PDT <br /> Buyer/new owner name(print): 9A/btiutoatsi34t.5... <br /> >~. Y ❑Right of survivorship Buyer/new owner signature: Date: <br /> PP. <br /> : Buyer/new owner name(print): 0 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 • <br /> I affirm that I am the current owner of this structure and acknowledge that the seller is responsible for submitting notice <br /> of sale/change of ownership to the State of Oregon Building Codes Division or one of its county agents within 30 days of <br /> the closing of the sale[ORS 446.641(1)]. <br /> • <br /> 440-2952(7/19/COM) Page 4 <br />
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