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SECTION 6 NEW OWNER ACKNOWLEDGEMENT(One name per box) <br /> ❑Person ■❑Business ❑Trust ❑Guardian <br /> Legal Name:Scott 2004 Family Limited Partnership Phone:503-266-5488 <br /> (last,first vnitldle) - - - - _ , _ <br /> W Mailing Address:130 SW 2nd Avenue, Suite 103 <br /> Z ': <br /> CCity:Canby "_ State:OR ZIP:97013 <br /> Email:tomscott@scott-investments.com <br /> W Right of ❑yes ,0 No - <br /> Z Survivorship: _ - _ _ -_ <br /> Signature: Date: 3�/. /, . Zp <br /> 1p- - Tom Scott for Scott 2004 Family Limited Partnership [3_/A <br /> _ J <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> N Legal Name: Phone: _ - ' <br /> (last,first,middle) <br /> z Mailing Address: <br /> City: State: ZIP: <br /> 0 - - - <br /> "� : Email: <br /> W Right of ❑yes ❑No <br /> Z Survivorship: . <br /> Signature: Date: <br /> ❑Person ❑Business 0 Trust ❑Guardian <br /> tr'1 Legal Name: • -, <br /> CC <br /> (last,first,middle) Phone: <br /> z Mailing Address: <br /> City: State: . ZIP: <br /> Email: <br /> W Right of ❑yes ❑No <br /> `Z ` Survivorship: _. <br /> ' Signature: Date: <br /> 1 - _ <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> Legal Name: <br /> Phone: <br /> CC <br /> (last,first,middle) __ _ <br /> W- Mailing Address: <br /> - City: State: ZIP: <br /> Email: <br /> W Right of ❑Yes ❑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 /> 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(I). <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 /> t. <br /> Page 3 <br />