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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location: 8144 S Myrtle Road, Myrtle Creek, OR 97457 County: Douglas <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> - IF'BEING,MOVED,LOCATION CHANGES (including.city, state, ZIP) <br /> New location:126 Gates Hill Road, Gates, OR 97346 County: Marion <br /> ❑ Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> OWNER <br /> Current owner names: Brownson Logging Co <br /> Are you changing the name of an existing owner? n Yes n No <br /> Changing from: to: <br /> Home transfer by inheritance? n Yes n No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? n Yes I No If yes, attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑ Yes n No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust, or right of survivorship? n Yes n No If yes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> Schweitzer, Mark J <br /> Mailing address: Mailing address: <br /> 126 Gates Hill Rd' <br /> 1 Gates, OR 97346 2 <br /> Phone number: Phone number: <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 /> • <br /> 440-2952(7/19/COM) Page 3 <br />