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I further certify that each lessor, mortgagee, trust-deed beneficiary, lien holder of record, and security-interest <br /> holder has been listed on this notice, or if none are listed,that this structure is free and clear of all mortgages, <br /> deeds of trust, security interests, and liens and that I have the legal right to sell this manufactured structure. <br /> Seller/current owner name(print): Seller/current owner signature: Date: Q I release my interest in this structure. <br /> J& M Homes,LLC <br /> Phone: 503-908-8166 ❑ Iacknowledge this sale/change ofownership, <br /> but do not release my interest in the structure. <br /> Email: bbaxter@jandmhomes.cn <br /> Seller/current owner name(print): Seller/current owner signature: Date: ❑ t release my interest in this structure. <br /> Phone: ❑ I acknowledge this sale/change of ownership, <br /> but do not release my interest in the structure. <br /> Email: <br /> Seller/current owner name(print): Seller/current owner signature: Date: ❑ I release my interest in this structure. <br /> Phone: ❑ Iacknowledgethis sale/change of ownership, <br /> but do not release my interest in the structure. <br /> Email: <br /> Seller:/current owner name(print): Seller/current owner signature: Date: ❑ I release my interest in this stricture. <br /> Phone: ❑ Iackno�sledgethis sale/change of ownership, <br /> but do not release my interest in the structure. <br /> Email: <br /> *Pt,' .a f 4 <br /> R , Tt 9 sL( /O0- iftr. il�q• <br /> a d <br /> Security holder's name(print): Security holder's signature: Date: ❑ I release my interest in this structure. <br /> ❑ <br /> I acknowledge this sale/change of ownership, <br /> but do not release my interest in the structure. <br /> Security holder's name(print): <br /> Security holder's signature: Date: ❑ I release my interest in this structure. <br /> ❑ <br /> I acknowledge this sale/change of ownership, <br /> but do not release my interest in the structure. <br /> �ba N 4�' �,r �' �^ iat �y ,rte}mesad � o` � '� �_ m <br /> 4';;b's. it'.', ,. . �4J4 1:,;'- am is r, a_3 .i. j+vdr S,uta a?_ # -ti.. =.k•.- 2§�w't *, A-f aN"-':3* <br /> ❑ <br /> Signatures from all applicable parties must be complete(current owners/sellers, new owners/buyers,and security <br /> interest holders). <br /> ❑ <br /> A valid tax certification from the county tax assessor.The tax certification form will be provided by the county <br /> office and must be signed by a county official. <br /> ❑ Any additional documents needed to establish your authority to buy/sell this home as required by ORS 446 <br /> and OAR 918 and posted at www.oregon.gov/bcd. <br /> If the home is being moved to a different county,a valid tax certification form is needed from both: <br /> ❑ (A)the county the home is moving from and <br /> (B)the county the home will be moved to <br /> ❑ if recording in or removing from county deed records, you must also submit a copy of the recorded <br /> application (Form 5176 or 5175 found at www.oregon.gov/bcd) <br /> ❑ if signing by Power of Attorney, submit a Change Affidavit (Form 5221). <br /> ❑ if this application is being submitted by the seller, you must also submit a bill of sale. <br /> 440.2952(7/I7/CONI) Page 5 <br />