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_ 7 `' CURRENT L O_CATION INFOR QTION (includ ng city, state, ZIP)'' ! Current location: 2555 Progress Way,Woodburn, OR. 97071 County: Marion 0 Dealer lot Dealer name: Factory Expo Homes Dealer license number: MSD 448 ❑Park name(if applicable): Out-of-state/federal or tribal property location •,�., s r 1 BfEING MOUED, LOCATION CHANGES lmcludmg y cit _state, ZIP ; ti New location: 21277 Hazelnut Ridge Rd. Scotts Mills, OR. 97375 County: Marion ❑Dealer lot Dealer name: Dealer license number: ❑Park name(if applicable): Out-of-state/federal or tribal property location: { tr 't. ss J;E I{.y t f a bil 4:'G f !.�C t4✓? s x J d J " R t i { t rr 1 J �pr�yip� ,1 x 1 .fr' .✓rT ?. Current owner names: Alta Cima Corp. Are you changing the name of an existing owner? Yes ❑No Changing from: Dealer to: Owner Home transfer by inheritance? [' Yes 0 No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) Home transfer due to foreclosure? ❑Yes Q No If yes,attach Affidavit of Repossession(Form 3926) Home transfer through abandonment process? ❑Yes •No If yes,attach Abandonment Affidavit(Form 2951) h divorce trust or right of survivorship? If yes,attach Change Affidavit Home transfer through g p. ❑Yes ❑� No (Form 5221) BUYEWNEWOWNERIN FQRMATIQN lone name pebox} � Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): Delany Family Trust Mailing address: Mailing address: 21318 Hazelnut Ridge Rd. Scotts Mills, OR. 97375 1 2 Phone number: Phone number: ' Email address: Email address: Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): Mailing address: Mailing address: 3 4 ❑ Same as above ❑ Same as above Phone number: Phone number: Email address: Email address: 440-2952(7/17/CoM) Page 3