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.----- <br /> . .• •..• ..• -. <br /> SECTION 6 .. .. .' ;:. : . NEW OWNER ACKNOWLEDGEMENT(One name per boi)•, ,''•••-''.-• •• '- e ''' ,'Y • ' ''._•' .i ' • <br /> .. _ El Person D Business 0 Trust D Guardian <br /> . . <br /> t : Legal Name: Phone: <br /> •• <br /> . • cc'. (last,first,middle)Cain, Terry , <br /> Mailing Address:5073 Keene Rd. NE <br /> :••• City:Gervais State:Or ZIP:97026 .. <br /> Email: <br /> • , <br /> .U1 Right of . ' <br /> Z.• Survivorship: RE Yes 0 No <br /> , . . <br /> Signature: Date: <br /> ,.. D Person 0 Business 0 Trust • 0 Guardian <br /> Legal Name: , <br /> N Phone: <br /> (lag first,middle) <br /> Mailing Address: <br /> Z . <br /> - ' City: State: ZIP: • <br /> o <br /> Email: <br /> • <br /> W Right of I-I <br /> U Yes 0 No <br /> Z Survivorship: <br /> Signature: Date: <br /> • <br /> .• -.L. <br /> 0 Person 0 Business 0 Trust 0 Guardian <br /> . . <br /> • • <br /> -, Legal Name: <br /> en Phone: <br /> cc.. (last,first,middle) <br /> Mailing Address: <br /> City: State: ZIP: <br /> 0 . <br /> Email: <br /> Right of .---, <br /> .' Z*: Survivorship: Yes 0 No <br /> Signature: Date: <br /> . . <br /> 0 Person D Business D Tnist 0 Guardian <br /> ..,- ... <br /> Legal Name: Phone: <br /> te (last,first,middle) <br /> Mailing Address: <br /> Z . <br /> City: State: ZIP: <br /> 0 . <br /> Entail: .. <br /> • <br /> Right of . <br /> Z 0 Yes 0 No <br /> Survivorship: .. <br /> • Signature: Date: <br /> . . <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 />