Requester: State of Oregon, Oregon
Department of Human Services

Recipient: Bethelle, Margie A.

After recording,

return to: Estate Administration Unit

2026-004625

Klamath County, Oregon

A0 0 DA

00356677202600046250
05/26/2026 12:41:25 PM Fee: $87.00

Attn: Mary Sterling
Oregon Department

of Human Services
P.O. Box 14021

Salem, OR 97309-5024

TERMINATION OF REQUEST FOR NOTICE OF TRANSFER OR ENCUMBRANCE

This termination pertains to the following described Request for Notice of Transfer or Encumbrance, recorded pursuant
to Oregon Revised Statutes 93.268, 205.246 and 411.694:

Recipient's Name: Bethelle, Margie A.
Recipient's ODHS Identifier / EAU#. YD600P3U / 505971
Request Recording Date: 11/08/2021

Request Recording Reference: 2021-016820
County of Recording: Klamath

The Oregon Department of Human Services has determined that notice of transfer or encumbrance of the real property
described in the above referenced Request for Notice no longer is required. Pursuant to such determination, the
Department hereby releases and terminates its above referenced Request for Notice and discharges all requirements
for notice of transfer or encumbrance by reason of the above referenced Request for Notice.

Executed this 20" Day of May , 20 26
ORE INISTRATION UNIT)

By:
Name) S
Title: Administrative Specialist
STATE OF OREGON, County of Marion ;
The foregoing was acknowledged before me this 20th  day of _ May ,20 26
by [name:] Ted Ash as [title] Administrative Specialist  of the Estate

Administration Unit of the Oregon Department of Human Services on its behalf.

=5 OFFICIAL STAMP
(%70 Barbara Dawn HamptonReyes
? NOTARY PUBLIC - OREGON

COMMISSION NO. 1053624

/ //_, / //20 Z 8 L MY COMMISSION EXPIRES November 1 1,2028

Notary Public for Oregon
My commission expires:

DHS 0523 (Revised 11/19/2020)