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DocuSign Envelope ID:E02F13C2-EE7D-43AD-B351-5972506AF3D6 <br /> • <br /> :I.EMON�6`::•':'�`3i•_'' '',ii ` `AI NEYV`bWNER AC NOWL� <br /> .... ... .... .. :.: :. . MT'Oiie-na••e.per•bek) :i•:`7.';:::.°<:;:=:::i;: ::•::: <br /> =;.;. 0 Person Musiness 0 Trust ❑Guardian <br /> ` a Legal Name: Barnett, Margaret for Barnett Farms&NurseryLLC Phone:503-866-9024 <br /> •a;�s (last,first,middle) 9 <br /> 1+1:1 Mailing Address: 12814 Arndt Rd. NE <br /> Asti city: Aurora state:OR zIP: 97002 <br /> .' 4 Email: mhaenerl @yahoo.com <br /> ii <br /> ;: i , Right of ❑Yes ❑No <br /> ' �"'! Survivorshi <br /> • � p Docu8laned bv: <br /> •,r; Si ature�.G <br /> /" ��.,� Date: 10/11/2023 12:03 PM <br /> ❑Person eea4013e7Dee14nn... ❑Business 0 Trust D Guardian <br /> Legal Name: <br /> Oast first,middle) Phone: <br /> .-:Wri':ZrtiAddress: <br /> • Mailing <br /> City. State: ZIP: <br /> -' . _ <br /> iI ire. Email: <br /> ' W li Right of ❑Yes ❑No • <br /> .,iZ : Survivorship: <br /> Signature: Date: <br /> 0 Person ❑Business El Trust • ❑Guardian <br /> J`f °' Legal Name: <br /> (last first middle) Phone <br /> ;eIWlr• Mailing Address: <br /> ; <br /> City: State: ZIP: <br /> oj, - <br /> ;, •Email: - <br /> :i 1ri: Right of ❑Yes ❑No <br /> • Z''' Survivorship: <br /> iiS' <br /> Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian • <br /> :;*; Legal Name: Phone <br /> _;?& (Iasi,first,middle) • <br /> - ' 11f. Mailing Address: <br /> :•;: +a ` City: State: ZIP <br /> : Email: • <br /> 4,100. Right of <br /> 'Z 4r. 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 />