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<br /> Current location:2555 Progress Way,Woodbum, OR. 97071 County:Marion
<br /> 0 Dealer lot Dealer name:Factory Expo Homes Dealer license number:MSD 448
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> fee e t t0010.
<br /> t# ifSc }.afN r l
<br /> New location: 6638 Cottonwood St. NE, Salem, OR. 97317 County: Marion
<br /> ❑Dealer lot 1 Dealer name: I Dealer license number:
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> Current owner names:Alta Cima Corp.
<br /> Are you changing the name of an existing owner? 0 Yes ❑No
<br /> Changing from:Dealer to:Owner
<br /> Home transfer by inheritance? ❑Yes 0 No If yes,attach appropriate Inheritance Affidavit(Form 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? n Yes 0 No If yes,attach Abandonment Affidavit(Form 2951)
<br /> Home transfer through divorce,trust,or right of survivorship? If yes,attach Change Affidavit
<br /> g g p ❑Yes 0 No
<br /> (Form
<br /> 5221)
<br /> + ;411041T DYR[NEWatatgtii� A7idet eperbax
<br /> it: ' g
<br /> "',•5, s +.- r.: l;at '<'r. +�,. s::I}.. rs� f,+: ,.e'-:
<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> Davidson,Kevin for The A.B.Davidson Family Trust
<br /> Mailing address: Mailing address:
<br /> PO Box 8021
<br /> I Salem, OR. 97303 . 2
<br /> Phone number: Phone number: -
<br /> 503-932-9949
<br /> Email address: Email address:
<br /> kevinldavidson@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(7/19/C0M) Page 3
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