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. SECT_ION'6.',. ;'; NEW OWNER ACKNOWLEDGEMENT O+ne:name perbox. `+'` <br /> ;�.• Person ❑Business El Trust ❑Guardian <br /> t—a, Legal Name: Phone:S3 i <br /> _ ,ce (last,first,middle) NO-1 K-L,S N t 9 C.LI 01 5 �`��c H ?-3( 6S <br /> W Mailing Address: S a p f V, •A A l 1J ST, *(c) <br /> '' _'; City:' M.D 17 NT Al..)Gs-EL State: O(2,— ZIP:.9136 z <br /> Email: <br /> Q1 ID.sar : .p 5 ! i • ,-„,,s <br /> W' Right of oa Yes ❑No <br /> ' 4, Survivorship: <br /> Signature: 007 51,K.GW - Date:7 izi 722)ZS <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> 4 Legal Name: <br /> ';.ce,j_ (last,first,middle) Phone: <br /> 1aJ Mailing Address: <br /> t.. City: State: ZIP: <br /> Email: <br /> W' .- Right of ❑Yes ❑No ... <br /> Survivorship: <br /> Signature: Date: <br /> ❑.Person ❑Business ❑Trust ❑Guardian <br /> `�.' Legal Name <br /> ,.-M���' Phone <br /> y r; (last first,middle) <br /> , .,:W.i <br /> Mailing Address: <br /> '.Z!: • . <br /> City: State: ZIP: <br /> O <br /> Email: <br /> W:' Right of ❑Yes ❑No <br /> Z. Survivorship: <br /> Signature: . Date: . .". ... .. <br /> t` <br /> .�Lp.; ❑Person ❑Business ❑Trust ❑Guardian <br /> d'; Legal Name: . Phone: . <br /> ;: ,.. (last,first,middle) <br /> .W Mailing Address: . . <br /> City: State: ZIP: <br /> Email: <br /> Right of ❑Yes ❑No <br /> _ ,2" 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 /> 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 Iisted,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens.. . . <br /> Page 3 <br /> i <br />