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,, <br /> SECTION 6 NEW OWNER ACKNOWLEDGEMENT(One name per box) __ __ <br /> •IN Person ❑Business ❑Trust ❑Guardian <br /> e— Legal Name: / ' I ' n �y <br /> (last,first,middle) VIAL'‘6:0-*`-: 9 0, t 9 I) I L/ L Phone: /�.3_:3“ 393? <br /> Z Mailing Address: R 0 4 3 \1 tr}Cv o0 )/,L i2 ,...ce <br /> OCity: ,SAL6r>7 State: e9 ZIP: 73,0 G. <br /> Email: ,)J/41./R-JL �/ A41 6m lL Co d)7 <br /> W Right of <br /> Z Survivorship: 'Yes ❑No / <br /> Signature: �� /74,d _ ile Date: ,V3,0/�3 <br /> Person ❑Business ❑Trust ❑Guardian <br /> Legal Name: y� <br /> cg (last,first,middle) 1,1 fC1W IO) ,2,g,4/nu/ 4015Phone��3 L>. + <br /> Z Mailing Address:�0 a 3,74e450A//l/C L ,ii (I) 5 6' <br /> City: -.2-4-/.4))') State: /Z ZIP:273c), <br /> 0 <br /> Email:0'))41 i Gl. IA . e -)YYI <br /> W Right of Yes ❑No JJ <br /> Z Survivorship: of&j // <br /> Signatur / /1, K. <br /> _ l/ ,ef,,.i--/ Date: 30- <br /> ❑Person ❑Bus' ❑Trust ❑Guardian <br /> M Legal Name: Phone: <br /> ce (last,first,middle) <br /> " Mailing Address: <br /> City: State: ZIP: <br /> 0 Email: <br /> WRight of 0 Yes El No <br /> Z . Survivorship: <br /> Signature: Date: <br /> 0 Person ❑Business ❑Trust ❑Guardian <br /> V' Legal Name: Phone: <br /> ce (last,first,middle) <br /> Z Mailing Address: <br /> City: State: ZIP: <br /> ® Email: <br /> WRight of El Yes El No <br /> Z 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 /> 1 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 />