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CURRENT;LOCATION INFORMATION (including city, state, ZIP) , Current location:3034 Continental SE,Turner, OR 97392 County: Marion n Dealer lot Dealer name: - Dealer license number: ❑ Park name(if applicable): Out-of-state/federal or tribal property location: ,IF BEING. MOVED, LOCATION pCHANGES (including city, state, ZIP) New location: 115/7 t C C) e ) I G.c R& ff U rr,,s i 1 •e. o K, County: in ar n ❑ Dealer lot Dealer name: Dealer license number: ❑ Park name(if applicable): Out-of-state/federal or tribal property location: OWNER , Current owner names: Dennis E Bethel, Cynthia M Bethel • t. Are you changing the name of an existing owner? n Yes n No Changing from: to: 1 Home transfer by inheritance? ❑ Yes 0 No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) Home transfer due to foreclosure? ❑ Yes ISI No If yes, attach Affidavit of Repossession(Form 3926) Home transfer through abandonment process? ❑ Yes n No If yes, attach Abandonment Affidavit(Form 2951) Home transfer through divorce,trust, or right of survivorship? n Yes XNo If yes, attach Change Affidavit (Form 5221) BUYER/NEW OWNER INFORMATION(one name per box) Buer/new owner name (Last,fast, middle):' Buyer/new owner name (Last,first, middle): li t0C-4.,-Drs :I:,- °;- tac.�, ; cc'e-(6-: -. , Mailin address: I Mailin ddress: 1! -R I i tI 9 7 rY c-c\ e\\�,N KLAS L IL/ 7 ii l cc l ie.\\(..v\ ,RA S . 1 ,A ti.,v,s .1\\-e 6K. 9 7 3 ES' 2 AA Imo-, s u \\-e 0 c 97 3 z.. Phone number: Phone number: .s o3—7 7 - 6/ 8 9 50 S--76-7 .- 67 F 9 Email address: Email address: ' dehn;$ 4 616.`/I Oc1(�2»Yt,r .c,,n,5,Saes. Cov+- Buyer/new owner flame (Last,first, m ddle): 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(7/19/COM) Page 3