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SECTION 6 °< : NEW OWNER ACKNOWLEDGEMENT.(0ne name per`box) <br /> ❑Person j Business ❑Trust 0 Guardian <br /> Legal Name. <br /> Salem Interfaith Hospitality Network Phone: <br /> : .;' (last,first,middle) <br /> `W Mailing Address:1055 Edgewater,St NW <br /> ,• �� city:Salem State:OR ZIP:97304 <br /> Email:tj@familypromisemwv.org <br /> W, Right of <br /> °Z Survivorship: Li ❑■ No <br /> signature �1 �`�— yyj-/' Date:12/8/2023 <br /> ❑Person .ram/ ❑Business ❑Trust 0 Guardian <br /> ' Legal Name: Phone: <br /> (last,first,middle) <br /> • ILI : Mailing Address: <br /> City: State: ZIP: <br /> Email: <br /> Right of ❑yes ❑No <br /> Survivorship: <br /> Signature: Date: <br /> ❑Person ❑Business ❑Trust 0 Guardian <br /> M, Legal Name: Phone: <br /> c, (last,first,middle) <br /> la'" Mailing Address: <br /> • Z <br /> City: State: ZIP: <br /> 0 <br /> Email: <br /> WRight of ❑yes ❑No <br /> Z'. Survivorship: - <br /> Signature: Date: <br /> 0 Person 0 Business 0 Trust ❑Guardian <br /> ; Legal Name: Phone: <br /> ,,cc_, (last,first,middle) <br /> LY Mailing Address: <br /> City: State: ZIP: <br /> Email: <br /> WRight 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 />