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613943
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Last modified
5/28/2026 11:04:20 PM
Creation date
5/28/2026 9:47:14 AM
Metadata
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Assessor
Account Number
613943
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
5/26/2026
MTL
042W040000800
Assessor Section
Manufactured Structures
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SECTION 7 NEW SECURITY INTEREST HOLDERS <br /> Security interest <br /> >: holder name: Phone: <br /> ;.•W Mailing Address: <br /> CI• <br /> W O - City: State: ZIP: <br /> IA X <br /> Email: <br /> Security interest <br /> } N. holder name: Phone: <br /> h- <br /> oC W. Mailing Address: <br /> W O City: State: ZIP:' <br /> Email: <br /> SECTION 8 ': •CURRENT OWNER ACKNOWLEDGEMENT <br /> All current owners (including security interest holders) must acknowledge the sale or change of ownership by signing the <br /> ownership document,signing the DMV title,OR completing the section below.Applications missing signatures will be rejected. <br /> Legal Name'J&M Homes LLC Phone:541-928-1471 <br /> (last,first,middle) <br /> Email:lsimon@jandmhomes.com <br /> . ❑ I release my interest in this structure ElI acknowledge this sale/change of ownership, <br /> V.,_0.::, but do not release my interest in this structure <br /> ='r ;'` Signature: Date: <br /> Name: <br /> (last,first,middle) Phone: <br /> Email: <br /> I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ <br /> but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> j-''i+r1 ` (last,first,middle) Phone: <br /> W ur_ Email: <br /> I acknowledge this sale/change of ownership, <br /> I <br /> 3`i ❑ release my interest in this structure ❑ <br /> but do not release my interest in this structure <br /> Signature: Date: <br /> Name: <br /> : (last,first,middle) Phone: <br /> Z . . <br /> W r W Email: <br /> cC Zet <br /> • I acknowledge this sale/change of ownership, <br /> ❑ I release my interest in this structure ❑ <br /> V O but do not release my interest in this structure <br /> Signature: Date: <br /> CURRENT OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that I am a current owner of this structure,and that I am responsible for submitting notice of sale or change of ownership to <br /> Building Codes Division or one of its county agents within 30 days of the closing of the sale per ORS 446.641(1). <br /> I further certify that I have the legal right to sell this structure,and that each lessor,mortgagee;trust-deed beneficiary, lien holder of <br /> record,and security interest holder has been listed on this notice.If none are listed,this structure is free and clear of all mortgages, <br /> deeds of trust,security interests,and liens. <br /> Security interest <br /> eC holder name: Phone: <br /> _ p Email: <br /> U I acknowledge this sale/change of ownership, <br /> LIJ <br /> _ ❑ I release my interest in this structure ❑ but do not release my interest in this structure <br /> tn <br /> Signature: Date: <br />• <br /> Page 4 <br />
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