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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location:3838 PALM HARBOR ROAD MILLERSBURG OR 97321 County:LINN <br /> 0 Dealer lot Dealer name:HOMES DIRECT OF OREGON LLC Dealer license number:MSD-523 <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:150 N BUTTE ST, DETROIT, OR 97324 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: <br /> Are you changing the name of an existing owner? ❑Yes ❑No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes Q No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes ❑� No If yes, attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes ❑� No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce, trust,or right of survivorship? ElYes M 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 /> BRUNELLE, MICHAEL J BRUNELLE, REBECCA <br /> Mailing address: Mailing address: <br /> 150 N BUTTE ST 150 N BUTTE ST <br /> 1 DETROIT, OR 97324 2 DETROIT, OR 97324 <br /> Phone number: Phone number: <br /> 951-531-3646 <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(7/19/COM) Page 3 <br />