600465 - Laserfiche WebLink

Home Browse Search

*i t tr`z Y t�( y �t-,y.Nl 7f-iyi r r d8 ,. L fy .z ,. � r t f )5 � t k ��T a L t i ? 1. ta?' t Y Yliy r +S { t s z tCURRENT;LOCATION iINFORMATIO'N4(includin.g GcItstate';ZIR f ��; � < 4 ' Y� Current Iocation:3838 PALM HARBOR DRIVE MILLERSBURG OR 97321 County:LINN iJ Dealer lot Dealer name:HOMES DIRECT OF OREGON LLC Dealer license number:MSD 523 ❑Park name(if applicable): Out-of-state/federal or tribal property location: C+,�;}',e�wt1 Leri t. �'1.� c a:.:;v;r,'�-:.•U?7.�ro- Z-�ftir: t y�:.,tif l9 h u.� r � V s. �C� IF BEING iMOVED LOCATION 1CHANGES (mciudIrig New location: 4p 02,44 Vs OK Gi 3 County: mart O v\ ❑Dealer lot Dealer name: Dealer license number:_ ❑Park name(if applicable): '^' '(V� "✓� Out-of-state/federal or tribal property location: f � Current owner names: Are you changing the name of an existing owner? ❑Yes ( No Changing from: to: Home transfer by inheritance? ❑ YesNo If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) Home transfer due to foreclosure? ❑Yes NNo If yes,attach Affidavit of Repossession(Form 3926) Home transfer through abandonment process? ❑Yes JNo If yes, attach Abandonment Affidavit(Form 2951) Home transfer through divorce,trust,or right of survivorship? 111Yes rNo If yes, attach Change Affidavit (Form 5221) BUYER/NEW OWNER INFORMATION (one name per box) Buyer/new owner name(Last,first, middle): Buyer/new owner name (Last,first, middle): LOCCSD Lei _a - , V ti o�-1 Y Mailing2 ,L/k �� l address: a Mailing address: C 6,A-1& QA, 73 t-{(, 2 GATtS C,Z-- Q-1 3 Ca Phone number: -tit 9kS b$ 2;3 Phone number: Email address: Email address: Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): Mailing address: Mailing address: 3 4 ❑ Same as above ❑ Same as above Phone number: Phone number: Email address: Email address: 440-2952(7/19/COM) Page 3