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<br /> Current location:3838 PALM HARBOR DR NE, MILLERSBURG, OR 97321 County:LI NN
<br /> Q 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 /> New location:7928 STAFFNEY LANE NE, GERVAIS, OR 97026 County:MARION
<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 ❑® No
<br /> Changing from: to:
<br /> Home transfer by inheritance? n 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 yes,attach Change Affidavit
<br /> (Form 5221)
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<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> SCHLECHTER,MARY, D.
<br /> Mailing address: Mailing address:
<br /> 7928 STAFFNEY LANE NE
<br /> 1 GERVAIS,OR. 97026 2
<br /> number:Phone • Phone number:
<br /> 503-510-7432
<br /> U .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 /> D 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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