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<br /> Current location:3838 PALM HARBOR DR NE, MILLERSBURG, OR 97321 County:LINN
<br /> I Dealer lot Dealer name:HOMES DIRECT OF OREGON Dealer license number:MSD523
<br /> ❑ Park name (if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> rl_FF;BEING,MO$,.jED;q;LOGATIONrCH'AtNGES (ihciudingcity,rstate;ZIP) .
<br /> New location:22105 JENNIE RD., LYONS, OR 97358 County: nbanon,
<br /> ❑ Dealer lot Dealer name: Dealer license number:
<br /> ❑ Park name(if applicable): •
<br /> Out-of-state/federal or tribal property location:
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<br /> Current owner names: HOMES DIRECT OF OREGON
<br /> Are you changing the name of an existing owner? ❑ Yes is No
<br /> Changing from: to:
<br /> Home transfer by inheritance? ❑ Yes n No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? ❑ Yes 0 No If yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer through abandonment process? n Yes n No If yes, attach Abandonment Affidavit(Form 2951)
<br /> If yes,attach Change Affidavit
<br /> Home transfer through divorce,trust,or right of survivorship? ❑ Yes 0 No (Form 5221)
<br /> ; # A, 'BUY; RINEW�OV(CNER (y OMA ,IONI(orenameper'boxt t �t .
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<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name (Last,first, middle):
<br /> MORRIS, DIANA, G.
<br /> Mailing address: Mailing address:
<br /> 22105 JENNIE RD
<br /> 1 LYONS, OR 97358 2
<br /> Phone number: Phone number:
<br /> 503-551-4337
<br /> Email address: Email address:
<br /> Buyer/new owner name (Last,firs!, middle): Buyer/new owner name (Last,firs!, 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(7/17/COM) Page 3
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