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• <br /> SECTION:6 .. .:-. NOV.OVItait CKNOWWLEOG IIENT(0►te Oit.liaxl: - , <br /> Parson 0 Business 0 Trust 0 Guardian <br /> • <br /> Legal Na me'Kerr John A Phone:541-815-1322 <br /> ac.. Rat,find,middle) • <br /> •t;Y. Mailing Address:52907 Walker Way <br /> Z <br /> 0 City:La Pine State:OR z[P:97739 <br /> Email: <br /> Right of ®Yes [i No <br /> Z Survivorship: <br /> Signature: Zolj � Date: q-ato...• <br /> ��a3 <br /> Person 0 Business 0 Trust 0 Guardian <br /> Legal Name:Kerr, Judy M Phone:541-815-1322 <br /> :it, (last,first,middle) <br /> W : Mailing Address:52907 Walker Way <br /> city:La Pine state:OR z1P:97739 <br /> 0 Email: <br /> Right of <br /> � ;iriCI No <br /> Z Survivorship: �� <br /> Signature: Date: [-Otc-aba3 <br /> 0 Person 0 Business 0 Tr at 0 till Legal Name: Phone: <br /> :cc : (lost,first,middle) <br /> Mailing Address: <br /> -Z. <br /> City: State: ZIP: <br /> Q. Email: <br /> Rightof []Yes i]No <br /> o Survivorship: <br /> Signature: Date: <br /> • <br /> o Person 0 Business 0 Trust 0 Guardian <br /> Legal Name: <br /> ::. '• (lasIJrrst,middle) Phone: <br /> Z . Mailing Address: <br /> • <br /> 3 City: l State: ZIP: <br /> Email: <br /> t� Right of u Yes Q No <br /> Z Survivorship: <br /> Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALEICHANGE 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 isrsilble 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 alter 30 days,I <br /> may complete the filing under ORS 446.64(I). <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 fist,security interests,and liens. <br /> Page 3 <br />