Laserfiche WebLink
• <br /> CURRENT LOCATION INFORM{ATION :(�ncludrng city,state, ZII') w <br /> Current;location: 33964 OAKVILLE RD SW ALBANY OREGON 97321 County;LINN <br /> ealer lot Dealer name:LEISURELAND HOMES INC Dealer license number•:MSD119 <br /> ❑Park name(if.applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOV ED LOCATION CHANCGES(includinn}g city,,state, ZIPS s ' ,: <br /> New location: 49 IC ^ tlc �& Ii jigg O . ! 30 �. County: 44( <br /> ❑ <br /> Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> a ti OYrNER 'r rrt -x t + _ _ <br /> Current owner names: <br /> LEISURELAND HOMES.INC <br /> Are you changing the name of an existing owner? Yes o <br /> Changing from: __ - •. , e e : - - - -: :- <br /> Home transfer by inheritance? ❑ Yes 0 No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Hometransfer due to foreclosure? ❑Yes Q No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes 0 No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce, trust,or right of survivorship? ❑Yes: ❑■ No If yes,attach Change Affidavit <br /> (FOrm 5221) <br /> ' BI�YER/NEW'OWt ER INFORMATION (on name per , <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name (Last,first, Middle): <br /> DONALD COZAD PG,,A-N <br /> Mailing address: Mailing address: <br /> 4915 SWEGLE RD NE#48 <br /> SALEM OR 97301 ' 2 -am <br /> Phone number: Phone number: <br /> 503-269-7914 <br /> Email address: Email address:. <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> Mailing address: Mailing address:, <br /> 3 4 <br /> ❑ Same as above ❑ Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7119/COM) Page 3 <br />