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4•Y }� 2W <br /> m.... ;:Y _.. CURRENT/LOCATI0N INFORMATION'(mcludmg <br /> Current location:33964 OAKVILLE RD SW ALBANY OR 97321 County:Iinn <br /> Dealer lot Dealer name:LEISURELAND HOMES INC. Dealer license number:MSD119 <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> BEIN.P APVEP ii3.LP,CATIQNCHANEn Iudir g,city state, ZIPy' <br /> New location:7028 sunnyside rd se salem or 97306 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 /> tx > i q �. ... £; 554 - 4}; {;, 'S � S ray 1 t 2s 4 �, �� t .,� s,' ,L i7 b--' h'. x{ tn1+•t,�� �' <br /> Current owner names: <br /> LEISURELAND HOMES INC <br /> Are you changing the name of an existing owner? Q Yes ❑No <br /> Changing from:LEISURELAND HOMES INC to: Eugene Riehart+Jake Buckendorf <br /> Home transfer by inheritance? ❑ Yes Q 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? ❑ Yes n No If yes, attach Abandonment Affidavit(Form 2951) <br /> If <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes 0 No yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION'(on� nav a per'box),"h t?Y h> Z4t, n sr , ,?} <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> RIEHART, EUGENE .; BUCKENDORF ,.JAKE <br /> Mailing address: ., Mailing address: <br /> 4285 COMMERCIAL ST SE 4837 VIEWCREST RD S <br /> 1 SALEM OR 97302 2 SALEM OR 97302 <br /> Phone number: Phone number: <br /> 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 /> ❑ Same as above ❑ Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) Page 3 <br />