Seturned a2t Counter

After recording return to:

C‘)‘UYAQV\ MLDW\CN\A

Send all future tax bills to:

2026-004833

Klamath County, Oregon

003569232

06/01/2026 11:53:50 AM

0260004833003

0034

Fee: $97.00

APPLICATION FOR RECORDING MANUFACTURED HOME AS REAL PROPERTY

Check appropriate box: ¥ Ncw home o Existing home - X Plate Number (if applicablc)
LEGAL DESCRIPTION OF MANUFACTURED STRUCTURE
YEAR MAKE HUD NUMBER VEHICLE IDENTIFICATION NUMBER (VIN) | WIDTH LENGTH
2025 |CAVED CAVAIORAS- 2SIpyAfp |26'8" 520"

HOME ID

COUNTY ID NUMBER | SITUS ADDRESS

- . ~—~———

2932 ALTAMONMT Pk KLAMATH FAUS

Legal description per ORS 93.600 or reference number of previously recorded deed. (Attach additiona'rs'lkets,'if 'nfc,d‘{d.))

Map and tax lot number:

4@ - PLPCA — PPBOP

PRINTED NAME OF OWNER(S)

GORDON MCDOMALD &+ REMNE M AL LEN

PRINTED NAME OF OWNER(S) (For additional owners, attach a second sheet)
GorDON MCIOMKLY F ENE M ALLENMN

MAILING ADDRESS (If diffcrent than situs address)

121 ACTAMOMT DE, KLAMBTH FALLS OR 94783

N o/ e

SECURITY INTEREST HOLDER NAME AND ADDRESS (If no sccurity intcrest holder, write “none.” Attach additional sheet if needed.)

ACKNOWLEDGEMENT

0/i /.90@&9

cctor or escrow officer

CERTIFICATION

I certify that, according to ORS 446.626:

Datc

¢ The same person owns the manufactured structure and the real property as described above on which the manufactured structure

is or will be situated OR

¢ The owner of the manufactured structure holds a recorded leasehold estate of 20 or more years of the land;
o The manufactured structure is or will be affixed to the real property and subject to taxation by the county in which it is located as

an improvemcnt to the real propcrty;

o Each person with a sccurity interest in the manufactured structure and cach person with a sccurity interest in the real property

approves the exemption from owncrship document; and

o This certification is being submitted for recording to the county clerk for the county in which the real property is located. A copy
of said recorded document is being provided to the county assessor in addition to the State of Orcgon Building Codes Division,
or onc of its county agents along with the County Manufactured Home Notification and Tax Certification Form for Used Homes

and a Manufactured 11lome Bill of Sale/Change A

X SIGNATURE OF OWNER

X SIGNATURE OF OWNER
State of Oregon, County of __ i tovaotn
The foregoing instrument was acknowledged before me this

V$+ day of J e ,202 6
by Gotden e &ene 4.
Signature of notarym__
My commission expires: Seot. Y+h o L=~
o~ Building
BCD &

Department of Consumer
and Business Services

440-5176 (12/24/COM)

lication.

50 ETHAN SCOTT CHEYNE

NOTARY PUBLIC - OREGON

. COMMISSION NO. 1051583

MY COMMISSION EXPIRES SEPT. 4, 2028
trvotary. seaty)

Pagc | 1

Additional sheet for legal description, if needed.

ALTAMONT Ackes 3RD ADbITION BLK-6 LOT- -

440-5176 (12/24/COM) Page | 2

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