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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location:33639 N Santiam Hwy Se, Gates OR 97346 County:Marion <br /> ❑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:33733 Railroad Ave Gates, OR 97346 County:Marion <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: 5-a^ed ;its ...K61,s a �% p <br /> Are you changing the name of an existing owner? n Yes ❑1 No <br /> Changing from:. / <br /> .40 1!'L y1.drA c G <br /> Home transfer by inheritance? n Yes MI 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 El No If yes, 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 /> Craig Stevens <br /> Mailing address: Mailing address: • <br /> 33733 Railroad Ave <br /> 1 Gates, OR 97346 • 2 <br /> Phone number: Phone number: <br /> 503428-8979 <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 ❑ Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) Page 3 <br />