Laserfiche WebLink
1. <br /> NEW SECURITY-INTEREST HOLDERS <br /> Security-interest holder name: <br /> a •_ <br /> -a Mailing address: <br /> B <br /> V <br /> G <br /> rn <br /> Security-interest holder name: <br /> ,° Mailing address: <br /> u <br /> V <br /> 0 <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 /> tisale/change of ownership. <br /> wI understand that the home cannot be relocated without first completing this form and purchasing a trip permit from the <br /> t State of Oregon, Building Codes Division or one of its county agents. <br /> rz <br /> S I understand that the seller/owner is responsible for submitting this.Ownership Document Application to the State of <br /> j Oregon, Building Codes Division or one of its county agents wiihin 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, I may complete the filing [ORS 446.641(1)]. [ further <br /> c: 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): 0 Right of survivorship Bu ,er/new owner signature: Date: <br /> /2-4 .,, , 1,2/ <br /> c, Buyednew owner name(print): ❑ Right of survivorship Buyer/new owner signature: Date: <br /> O. <br /> CI <br /> ° Buyer/new owner name(print): ❑ Right of survivorship Buyer/new owner signature: Date: <br /> u <br /> >. <br /> m <br /> Buyer/new owner namerint <br /> (p ) ❑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 Honie 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 I affirm that I am the current owner of this structure and acknowledge that the seller is <br /> responsible for submitting notice of sale/change of ownership to the State of Oregon Building Codes Division or one of <br /> 'its county agents within 30 days of the closing of the sale[ORS 446.641(1)]. <br /> 440-2952(7/I7ICOM) Page 4 <br /> • <br /> . ,._ _ ,'i' .::? :.,"^ .`_ _, ti,L.c .r'?° Wiz, § # �Rc4ix„''&'t:$�nkiy'ras..9 <br />