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• <br /> • <br /> SECTION 6 NEW OWNER ACKNOWLEDGEMENT(One name per box) <br /> . 0 Person ❑Business ❑Trust ❑Guardian <br /> Legal Name:Lutz D phone:971-375-7755 <br /> cc (last,first,middle) 9 Timothy, <br /> Ill Mailing Address:,PO Box 455 <br /> City:Detroit State:OR ZIP:97342 <br /> 0 <br /> Email: <br /> Right of 0 Yes ❑No • <br /> Z Survivorship: • <br /> Signature: • • Date: <br /> 0 Person ❑Business • ❑Trust ❑Guardian <br /> N Legal Name:Lutz, Cindy, B <br /> tY (last,: rst,middle) Phone: <br /> Ili Mailing Address:.PO Box 455 • <br /> • <br /> 0 City:Detroit State:OR ZIP:97342 . . <br /> Email: <br /> 6L Right of ❑' Yes ❑No <br /> Z Survivorship:- . <br /> • Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian -. <br /> en Legal Name: Phone: <br /> c4 (last,first,middle) <br /> Z Mailing Address: <br /> 0 <br /> City: State: ZIP: <br /> Email: • <br />. W Right of ❑Yes ❑No <br /> Survivorship: <br /> • Signature: Date: <br /> 0 Person 0 Business 0 Trust ❑Guardian <br /> d. . Legal Name: <br /> 04 (last,first,middle). Phone: <br /> 2 Mailing Address: <br /> 0 <br /> • City: State: ZIP: <br /> Email: <br /> W Right of ❑Yes ❑No <br /> 2 Survivorship: <br /> Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change <br /> of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip permit <br /> from the Building Codes Division or through one of its county agents. <br /> -I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all <br /> buyers and sellers will be notified by mail when the application is approved.If the application has not been submitted after 30 days,I <br /> may complete the filing under ORS 446.64(1). <br /> I understand that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security interest holder must be listed on <br /> this notice.If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> Page 3 <br />