Laserfiche WebLink
DocuSign Envelope ID:34F982E3-3576-46E2"y ``!B-6F5419FB55F0 <br /> 1538344 <br /> SECTION 6-. , .,. ,:, E OWNER ACKNOWLEDGEMENT(one nname r box)i :£a <br /> Person [Business n Trust E Guardian <br /> 2. ' Legal Name: Murphy Daniel <br /> lV (l ts0131 middle)..... Phone: <br /> '7,.r. Mailing Address: <br /> . l:'$ ^Email. State: ZIP _ <br /> R giht f:�;Lja;; r-Yes ENo <br /> . ..Survivor*oP,r—o...simee try: <br /> '; Signature: Date: 10/5/2023 <br /> BCC34F&IF446._ <br /> �� E Business Trust Guardian -- <br /> :.'12'<°._ Legal Name: Dowers-murphy Theresa Phone: <br /> Ll4!_ (last,first,middle) <br /> Milli Address: .. - <br /> ':;C). City: State: I ZIP: <br /> Email: <br /> Right of �—Yes No t <br /> : <br /> z SurYtvorshi :—onn,Sl�nPn„y. <br /> Signet e SA. 06WVS IlturpLiDate: 10/6/2023 <br /> h9oeEeo34499... [Business 0 Trust [Guardian <br /> it: Legal Name: <br /> LIJ- (kW,first,middle) Phone: <br /> ng Address: <br /> :•—' Msuli City: State: ZIP: <br /> A Email: <br /> LLI Right of r Yes I-- <br /> No <br /> zSurvivorship: <br /> Z <br /> Signature: Date: <br /> ,V r Person r Business n Trust r Guardian <br /> to Legal Name: <br /> Liu Raster middle) Phone: <br /> ZMailing Address: <br /> City: State: ZIP: <br /> Email: — <br /> ILI Right of r Yes ENo <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 <br /> change of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip <br /> permit 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, <br /> I 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 /> 440-2952(11/22lBCD) Page 3 <br /> OR Title Application-7/2023-TitleApp 11211 004786514-90006 <br />