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Get And Sign STATE OF OREGON, County Of Ss I, , Being First Duly Sworn Form

Address ss. SPACE RESERVED FOR RECORDER S USE After recording return to Name Address Zip Witness my hand and seal of County affixed. NAME By TITLE Deputy. The following annual labor has been performed or improvements have been made for the above-named claim Number of days labor performed Value of Improvements Character and location of improvements qualifications for waiver have been met including filing certified statement of waiver. Notary Public for Oregon My commission expires Oregon law ORS...

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