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. <br /> . • : " • 4 ' • i! <br /> 7 ! C,URRENT'liOCATION,114F-oRNIATIPNVOCIVOrrAAtY4 SOstczi ZIP) <br /> Current location:IX/X.1S,Jubb Rd Estacada,OR 97023 County:Clackamas <br /> E Dealer lot Dealer name: Dealer license number: <br /> 0 Park name(if applicable): • <br /> Out-of-state/federal or tribal property location: <br /> • ": 7 • s " sir . • . ' .:VAZfgPie <br /> : 0C-AIIIPN:PIANPE§.(IACIOIP city,.stg%ZIP) <br /> New location:2229 Walla Rd NE Woodbum, OR v97071 County: Mail 011 <br /> 0 Dealer lot Dealer name: Dealer license number: <br /> 11 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> 4i; "Acer <br /> *.FTWgivztv-K,4 LP 4,- 3,-•(01*, Ep —n <br /> ali* <br /> •:!!'A.N% r;i! . .L A !. • <br /> Current owner names:Dennis Gross <br /> binnt M eArD6S <br /> -Are you changing the name of an existing owner? 0 Yes 0 No <br /> Changing from:Dennis Gross to:Petr Anffiofieff <br /> Home transfer by inheritance? Ei Yes El No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? 0 Yes 0 No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? 0 Yes EI No If yes, attach Abandonment Affidavit(Form 2951) <br /> If yes,attach Change Affidavit <br /> Home transfer through divorce,trust,or right of survivorship? 0 Yes #No <br /> (Form 5221) <br /> 1 3" ••• • - - '• , • :Y;.!'-; <br /> • ; •.1 RPKANYINPP.Nj9P5MTIle per <br /> e., Buyer/new owner name(Last,first,middle): 0.4 Buyer/new owner name(Last,first, middle): <br /> Anfilofieff Petr G ti <br /> ; Mailing address: -1.1-; Mailing address: <br /> PO BOX 243 <br /> Woodburn:OR 97071 - <br /> 1 <br /> Phone number: Phone number: <br /> 503-428-4960 <br /> Email address: Email address: <br /> hoodviewconstruction@gmail.com <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> .1 <br /> I. • <br /> ir <br /> Mailing address: '4, Mailing address: <br /> 0 Same as above 0 Same as above <br /> I" Phone number: Phone number: <br /> Email address: 1, Email address: <br /> 440-2952(7/19/COM) Page 3 <br />