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11/23/2020 07:27AM ' 5038242406 AHB AI PAGE 02/06
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<br /> Current location:15995 S. HWY 211 MOLALLA,OREGON 97038 County:CLACKAMAS
<br /> ❑Dealer lot Dealer name: Dealer license number:
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> New location:814 N.SANTIAM HWY.WEST GATES,OREGON 97436 County:MARION
<br /> ❑Dealer lot Dealer:name: - Dealer license number:
<br /> ©Park name(if applicable):
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<br /> Out-of-state/federal or tribal property location:
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<br /> Current owner names:
<br /> KEITH J. ROSENTHAL
<br /> TAMMY L. ROSENTHAL
<br /> Are you changing the name of an existing owner? Yes E No
<br /> Changing from: to:
<br /> Home transfer by inheritance? 0 Yes 7 No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? Q Yes 0 No if yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer throughabandonment process? ❑Yes [O No If yes,attach Abandonment Affidavit(Form 2951)
<br /> If yes,attach Change Affidavit
<br /> Home transfer through divorce,trust,or right of survivorship? Q Yes n No (form 5221)
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<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> EDGE, BILLY EDGE, BROOKE
<br /> Mailing address: _; Mailing address:
<br /> 814 N.SANTIAM HWY.WEST 814 N.SANTIAM HWY.WEST
<br /> GATES,OREGON97436 2 GATES,OREGON 97436
<br /> Phone number: • Phone number:
<br /> Email address: _ Email address:
<br /> Buyer/new owner name first, middle): Buyer/new owner name(Last,first, middle):
<br /> Mailing address:7. Mailing address:
<br /> 3 4
<br /> 0 Same as above` 0 Same as above
<br /> Phone number: - : Phone number:
<br /> Email address: Email address:
<br /> Page 3
<br /> 440-2952(7/17/COM) ;
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