359522 - Laserfiche WebLink

Home Browse Search

DocuSign Envelope ID:65E51 FEO-B5F0-4936-9834-B32EE55D8219 • 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 this manufactured structure. Seller/current owner name(print): Seller/current owner signature: Date: Q r release my interest in this structure. Alta Cima Corp. Phone: 77/427.-D/�W� 05/22/2020 ❑ 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: ❑ i release my interest in this structure. Phone: ri 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: ❑ I release my interest in this structure. Phone: 1 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: ❑ 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. �r''.Y�6 �L�G. � ti � �� . .,��<<:�L.'1'21rADY�O��T�fCt3�tT5r,i a�. Security holder's signature: Date: ❑ I release my interest in this structure. Security holder's name(print): ❑ I acknowledge this sale/change of ownership, but do not release my interest in the structure. Security holder's signature: Date: El release my interest in this structure. Security holder's name(print): T acknowledge this sale/change of ownership, ' � �n �,y �� rr but do not release my interest in the structure. n... w,tiP f�i� �"`3�.a�e+tiirb"s°`'"�s(y��1 R� �r '..- v �1 .j�.y��tyy�.„r(��r<.i y,�17 :fFn Yr(''ti.,�r{/ryyyy/ -u - a2'r ,7L r.,`.. yt.�GJ -:�.,,rT?�i�r .,..,a%rit:44„Abf,R',yF,,f+^ '{,�t:i.4't % YeWtq SS 3�'�.4 �[ l l �l �1�� 1�LV l'I �I 4L 1` � D l i t Jl ,y, 0S SVS ... X.n.e,.... .r-},t.W..? r .i f;�. x t i 's�r�7c�Y t f.✓Y.s�t s�,'..�t srl'i n'' ;5:,>< r r.•,. �� r ❑ Signatures from'all applicable parties must be complete(current owners/sellers,new owners/buyers,and security interest holders). ni❑ 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/bed. 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 county the 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). ❑ If signing by Power of Attorney, submit a Change Affidavit(Form 522I). ❑ If this application is being submitted by the seller,you must also submit a bill of sale. • • 440-2952(7/19/COM) Page 5