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• <br /> CURRENT LOCATION INFORMATION (Including city, state,ZIP) <br /> Current location:PALM HARBOR HOMES, 3737 PALM HARBOR DR, MILLERSBURG, OR WI County:LINN <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:20498 HWY 99E, N.,AURORA, OR 97002 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: CASCADE FACTORY HOMES, INC. <br /> Are you changing the name of an existing owner? 0 Yes ❑No <br /> • <br /> Changing from:CASCADE FACTORY HOMES, II l to:DANIEL&ALLISON CAULEY <br /> Home transfer by inheritance? ❑Yes 0 No If yes, attach appropriate Inheritance Affidavit(Form 2946 or p 177) <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 /> If yes, attach Change Affidavit <br /> Home transfer through divorce,trust,or right of sun;ivorship, [r]Yes ❑■ No - <br /> Form 521 <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 /> CAULEY, DANIEL <br /> Mailing address: Mailing address: • <br /> 20498 HWY 99E, N. <br /> ( AURORA, OR 97002 2 <br /> Phone number: Phone number: <br /> 971-209-9787 <br /> Email address: Email address: <br /> Buyer/new owner name(Last,first, middle): • . Buyer/new owner name (Last,first, middle): <br /> CAULEY,ALLISON <br /> Mailing address: Mailing address: • <br /> 3 4 <br /> El Same as above ❑ Same as above <br /> Phone number: Phone number: • <br /> 503-341-5809 • <br /> Email address: Email address: <br /> ALLIELEEPALLIE c@GMAIL.COM p <br /> a <br /> 44-0-2952(7.117/COM) Page 3 <br />