360634 - Laserfiche WebLink

Home Browse Search

DocuSign Envelope ID:F22AB349-941C-4DB6-E 7B48E3ADF062 1397019 I further certify that each lessor,mortgagee,trust-deed beneficiary, lien holder of record,and security-interest holder has been listed on this notice,or if none are listed,that this structure is free and clear of all mortgages, deeds of trust,security interests,and liens and that I have the legal right to sell thmanufactured structure. Seller/current owner name(print) Seller/current owner signature: Date: I release my interest in this structure. CLAYTON HOMES ALBANY, OR Phone:(541)967-8555 ' I acknowledge this sale/change of ownership, Email: ��:AL/1 • 0 r •but do not release my interest in the structure. Seller/current owner name(print) Seller/c'arrent owner signature: Date: ❑I release my interest in this structure. Phone: ID I acknowledge this sale/change of ownership, Email: but do not release my interest in the structure. Seller/current owner name(print) Seller/current owner signature: Date: D I release my interest in this structure. Phone: ❑I acknowledge this sale/change of ownership, Email: but do not release my interest in the structure. Seller/current owner name(prim) Seller/current owner signature: Date: D l release my interest in this structure. Phone: D I acknowledge this sale/change of ownership, Email: but do not release my interest in the structure. SECURITY-INTEREST HOLDER ALREADY ON RECORD(if applicable) Security holder's name(print) Security holder's signature: Date: D I release my interest in this structure. Vanderbilt Mortgage&Finance, ❑I acknowledge this sale/change of ownership, Inc. but do not release my interest in the structure. Security holder's name(print) Security holder's signature: Date: I release my interest in this structure. El I acknowledge this sale/change of ownership, but do not release my interest in the structure. PRIOR TO SUBMITTING, CHECK THE FOLLOWING: Signatures from all applicable parties must be complete(current owners/sellers,new owners/buyers,and security interest holders). Q A valid tax certification from the county tax assessor.The tax certification form will be provided by the county office and must be signed by a county official. • Any additional documents needed to establish your authority to buy/sell this home as required by ORS 446 and OAR 918 and posted at www.oregon.gov/bcd. El If the home is being moved to a different county,a valid tax certification form is needed from both: (A)the county the home is moving from and (B)the countythe home will be moved to ▪If recording in or removing from county deed records,you must also submit a copy of the recorded application(Form 5176 or 5175 found at www.oregon.gov/bcd). El If signing by Power of Attorney,submit a Change Affidavit(Form 522]). If this application is being submitted by the seller,you must also submit a bill of sale. 440-2952(7/19/COM) OR Title Application-10/2019-TitleApp11211 Page 5 004324926-00001