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• <br /> DocuSign Envelope ID:206FA44C-E5F8-43ED-9974-3A170A6C9248 • <br /> DocuSign Envelope ID:D3A00396-FEA4-40FB-B698-75E6476A1 B6F <br /> • <br /> SECTION 6 NEW OWNER ACKNOWLEDGEMENT(One name per box) <br /> ❑ Person 0 Business ❑Trust ❑Guardian <br /> Legal Name:Santiam River Holdings, LLC Phone:541-979-0118 <br /> • (last,first,middle) <br /> W Mailing Address:2125 Pacific Blvd <br /> city:Albany state:OR ziP:97321 <br /> Email:stevehelms©kw.com <br /> -;W • Right of ❑Yes "El No <br /> Survivorship;—Docusignedby: <br /> Signature; S • Date: 7/8/2024 12:15 PDT <br /> ••---EB5DE31BF23340E... <br /> ❑Person ❑ Business ❑Trust ❑Guardia • <br /> n <br /> Legal Name: Phone: <br /> (Iasi,first,middle) <br /> W Mailing Address: <br /> City: State: ZIP: • <br /> •®.. <br /> • Email: <br /> :W Ri• ght of• ❑Yes ❑No <br /> Z . Survivorship: <br /> Signature: Date: <br /> • <br /> ❑Person ❑ Business E Trust ❑ Guardian <br /> fY1 Legal Name: <br /> (last,firs!,middle) Phone: <br /> Mailing Address: <br /> City:. State: . ZIP: <br /> Email <br /> • <br /> Right of • <br /> g ❑Yes ❑No <br /> '.: Survivorship: <br /> Signature: Date: • <br /> • ❑Person ❑Business ❑Trust ❑Guardian <br /> .• Legal Name: . <br /> (lasi,first,middle) Phone: <br /> IJJ Mailing Address: <br /> City: State: ZIP: <br /> Email; <br /> W 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 />