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,- .�,�`i C`1JR NT ;OA ATtbNi l'I�fF"OgM', TION ("mbPocf'ng , _. _ . i <br /> Current location:33964 OAKVILLE RD SW ALBANY OR 97321 County:LINN <br /> ❑® Dealer lot Dealer name:LEISURELAND HOMES INC Dealer license.number:MSD 119 <br /> ❑ Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> �...; J EiNG` !OVED LOCA ION GH` NGES(a I><tdxn tzty,;state;Zip) {: <br /> New location: Q T. Si Oe.g173/� 'SD County 441 <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> • <br /> Out-of-state/federal or tribal property location: <br /> Current owner names: <br /> _CPA rr th- 1111.#1— <br /> • <br /> Are you changing the name of an existing owner? ❑Yes 0 No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes 0 No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes Q 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? ❑Yes Q No If yes.,attach Change Affidavit <br /> (Form X221) <br /> L � <br /> BUYERMEW OWNER INF,OF M? s 5 <br /> f t7 <br /> Buyer/new owner name(Last,first middle): Buyer/new owner name(Last,.first, middle) <br /> Co-r-p1,4 Q� <br /> Mailing address: Mailing address: <br /> 2200 Lail C ci- `11 St <br /> 1 S,4-4r 913/7 Sp /5 2 <br /> Phone number: Phone number: <br /> Email address: Email address:' <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name <br /> (Last,first, middle): <br /> Mailing address: Mailing address: <br /> • <br /> 3 4 <br /> ❑ Same as above ❑Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM), <br /> Page 3 <br />