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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location:CASCADE FACTORY HOMES INC 590 N Pacific Hwy Woodburn OR 97071 County:Marion <br /> D Dealer lot Dealer name: 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:27860 N SANTIAM HWY, MILL CITY OR 97360 County:LINN <br /> ❑Dealer lot Dealer name: 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? ❑Yes LI No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes 0 No If yes,attach appropriate Inheritance Affidavit(Fonn 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 Q No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes ❑■ No dyes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> JENSEN, MIKE <br /> Mailing address: Mailing address: <br /> PO BOX 396 <br /> 1 MILL CITY OR 97360 2 <br /> Phone number: Phone number: <br /> 503-897-4319 <br /> Email address: Email address: <br /> MIKEYRAYJI @GMAIL.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/I9/COM) Page 3 <br />