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357519
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Last modified
1/13/2022 5:59:50 AM
Creation date
6/10/2019 8:20:02 AM
Metadata
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Template:
Assessor
Account Number
357519
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
6/6/2019
MTL
071E11D000700
Assessor Section
Manufactured Structures
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' • <br /> CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> Current location:FLEETWOOD HOMES,2655 PROGRESS WAY, WOODBURN, OR 97071 County:MARION <br /> ❑Dealer lot Dealer name: 0 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:20096 N.ABIQUA RD,SCOTTS MILLS,OR 97375 County:MARION <br /> ❑Dealer lot Dealer name: I 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 /> Changing from:CASCADE FACTORY HOMES, if{ to:ROBERT B. QUALEY LIVING TRUST <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 El No If yes,attach Affidavit of Repossession.(Form 3926) <br /> Home transfer through abandonment process? ❑Yes 0 No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑ Yes 0 No If yes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner name(Last,first, middle): . [ I Buyer/new owner name(Last,first, middle): <br /> KUbbK 1 b. UUALEY LIVING T RUST <br /> Mailing address: Mailing address: <br /> 15256 FOX RD, S.E. <br /> 1 SILVERTON,OR 97381 2 <br /> Phone number:. Phone number: <br /> 503-551-6048 <br /> Email address_. Email address: <br /> BOB.QUALEY@YAHOO.COM • <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(7/17/COM) Page 3 <br />
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