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+i <br /> • ::CURRENTLOCATIONINFORMATION:(including•city,:state,.ZIP) ;* •:: .• : . <br /> Current location:185 47th Ave. N.E. Salem, Oregon 97301 County:Marion <br /> ❑Dealer lot Dealer name:Rizimmicittivert Brian L. Fitterer, Inc. <br /> Dealer license number:MSD410 <br /> Park name(if applicable): Royal Mobile Estates <br /> Out-of-state/f�deral or tribal property location: • <br /> • . •I IF BEING MOVED, LOCATION CHANGES (including city, state, ZIP). . . . . <br /> New location: County: <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: <br /> 1 <br /> Are you changing the name of an existing owner? Yes [No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes [ 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? fl Yes I No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes /l No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW.OWNER INFORMATION (one naine.per.box) . .. • . , • <br /> Buyer/neW owner name (Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> Salazar MaIrilou <br /> 1 <br /> Mailing address: Mailing address: <br /> 185 47th Ave.N.E. <br /> 1 Salem, Oregon 97301 2 <br /> Phone ndmber: Phone number: <br /> 503-999-7569 <br /> • <br /> Email address: Email address: <br /> • <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(7/19/COM) Page 3 <br />