|
(a, ribi�'fv�ro•h1n✓•fMM asrn. su�T,ar, rJ er. 7h� r .•.,..b. Im..enw,- f,�._.. }Y.ea«.i+• wn+.a}t ;s:1�Y.-.
<br /> Current location:2555 Progress Way,Woodburn,OR. 97071 County:Marion
<br /> ❑� Dealer lot I Dealer name:Factory Expo Homes I Dealer license number:MSD 448
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> •
<br /> �^ 'lH SWJrf2'�{y�hl U tF- y[1 M1yq 'myyVr:� r,,,{i]+(1�{¢�(., py[ID�+1-j.,�U A i r�7)Yry, y �+q�j �t- J'[7'
<br /> / - r+A,S 53i E'•o #. s..:m++A ..A. '�.rP`L `t ,T.n:.y�.:.!�"9' '.1 k7l..Y. .... ..,-. ,`fl„'' 1 eiff-�� 0e,A.0 4fPyts p� teel`.i
<br /> New location:11420 Rowena Ave.SE, Lyons,OR. 97358 County{ *Marion
<br /> ❑Dealer lot I Dealer name: I Dealer license number:
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> .. f f'{ �'i �(r x;k.�y.«tf- ,"',.'y7 �•'�rYtt. icti v �:;, e
<br /> f { � e ri�:,R,f� l�� �`N�Yik T' -::rA4t;.k` 0541,
<br /> 5�1St,a.,
<br /> Current owner names:Alta Cima Corp.
<br /> Are you changing the name of an existing owner? Q Yes ❑No
<br /> Changing from:Dealer to:Owner
<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 ©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 Q No If yes,attach Change Affidavit
<br /> (Form 5221)
<br /> Wit 1. v4.46,t, 0•cG C' "'7 4` l;(::..K tl<6 tg.. Y41 �'l' (fc'"L49'zFF i� t ' G r'r yJ„ �1r�F SA
<br /> Rh!EIWO
<br /> RMA
<br /> &,673.W441.7rx.vi. r asp? e5,tai .'�r,�""S--i _ +` �"9 .ds_�•s+r� rgs:# •�rtr. '�., c, +` �£`'�a,
<br /> Buyer/new owner name(Last,first,middle): Buyer/new owner name(Last,first,middle):
<br /> Adams, Dennis;
<br /> Mailing address: Mailing address:
<br /> 11420 Rowena Ave.SE,
<br /> •. Lyons,OR. 97358 2
<br /> • Phone number: r 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 I. ❑Same as above
<br /> Phone number: Phone number:
<br /> Email address: Email address:
<br /> •
<br /> 440.2952(7/19/COM) Page 3
<br /> e ,
<br />
|