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SECT# 16`'' ` NEW OWNER AC KN)WLEDGEIVIENT;(One name"Per box),, ; '', # ❑Q Person ❑Business ❑Trust ❑Guardian •- • Legal�Name- �*` CPI SUNDIAL OWNER, LLC Phone:503 244-2300.. ' (last,first,middle) 'N Mailing Address:18150 SW BOONES FERRY ROAD r City:PORTLAND State:OR ZIP:97224 Email: Right of Yes No Zi Survivorship: ❑ , - Signature: ('it'd.- - _ __. Date: (4_2_7.�: ❑Person ❑Business ❑Trust ❑Guardian _. `.t Legal Name: Phone: :; , (last,first,middle) , '..Mailing Address: ,, City: State: ZIP: . i_'_ " ' , _ Email: f iT ''" Right of El Yes ❑No Survivorship: Signature: Date: ❑Person ❑Business ❑Trust ❑Guardian 'A i ax , Legal Name: Phone: '. (last,first,middle) 'Y141 Mailing Address: City: State: ZIP: pEmail: t-,' Right of IT ❑No ,-, Survivorship: Signature: Date: E V;'.. ❑Person ❑Business ❑Trust ❑Guardian !` Legal Name:_ Phone: t�' (last,first,middle) Aij Mailing Address: City: State: ZIP: ,F w i Email: W Right of ❑Yes ❑No r 2 Survivorship: Signature: Date: NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP . I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip permit from the Building Codes Division or through one of its county agents. I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all 'buyers:and sellers will be notified by mail when the application is approved.If the application has not been submitted after'30 days,'I may'complete the filing under ORS 446.64(1). I understand that each lessor,mortgagee,trust-deed beneficiary, lien holder of record,and security interest holder nust be listed on, this notice. If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens Page 3