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t t�+ k'+Y .. . � � si`tez <br /> , • 9 ; <br /> Current location:3838 PALM HARBOR DR NE, MILLERSBURG, OR 97321 County:LINN <br /> Q Dealer lot Dealer name:HOMES DIRECT OF OREGON Dealer license number:MSD 523 <br /> ❑ Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> i ( ov„„wtemt <br /> New location:105 FOREST AVE E., DETROIT, OR 97342 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 /> Current owner names: HOMES DIRECT OF OREGON <br /> Are you changing the name of an existing owner? ❑Yes ❑t 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 ❑t No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑ Yes ❑t 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 ❑t No (Form 5221) <br /> EF�INEWI o NER fi��sol d' QN�t �l name Pyr box); {. <br /> 3 r <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> EVANS,JOETTA <br /> Mailing address. Mailing address: <br /> 05 FonsfAvai Ed <br /> tctro;K }I ' 47342 2 <br /> Phone num, Phone number: <br /> 541.979.5639 <br /> Email address: Email address: <br /> Buyer/nevv 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(7/17/COM) Page 3 <br />