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SECTION 6 NEW OWNER ACKNOWLEDGEMENT(One name per box) <br /> 0 Person ❑Business ❑Trust ❑Guardian <br /> Legal Name:COOKS JAYSON Phone: <br /> (lass,first.middle) <br /> Et <br /> 114.4 Mailing Address:3871 VICTOR POINT RD. N.E. <br /> City:SILVERTON State:OR. ZIP:97381 <br /> 0 <br /> Email: <br /> MA Right of en Yes ❑No <br /> Z Survivorship: i <br /> Signatur �j�f����L 6 Date:07-15-23 <br /> 0 Person //' ❑Business ❑Trust ❑Guardian <br /> iN Legal Name:COOKS MARLENE Phone: <br /> tt (last,first,middle) <br /> 142 Mailing Address:3871 VICTOR POINT RD. N.E. <br /> City:SILVERTON State:OR. ZIP:97381 <br /> 0 <br /> Email: <br /> EE-9 Right of Yes El No <br /> Z Survivorship: t <br /> Signatur)4 r1.(1�c_c i�/ � Date:07-15-23 <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> M Legal Name: <br /> Ot (last.first.middle) Phone. <br /> P1 Mailing Address: <br /> City: State: ZIP: <br /> 0 <br /> Email: <br /> !IJ Right of ❑Yes ❑No <br /> Z Survivorship: <br /> Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> Legal Name: Phone: <br /> ig (last.first,middle) <br /> III Mailing Address: <br /> City: State: ZIP: <br /> 0 <br /> Email: <br /> Eli Right of <br /> Z Survivorship: ❑Yes ❑No <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 />