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Doc.Sign Envelope ID:211 E0F06-82FB-454F-9E36-1606F1A6C227 <br /> °: `' -: .- CURRENT:LO:CATION:.INFORMAT.IO.N:(including city, state;ZIP):;..: ;. : ': <br /> Current location:83456 Rattlesnake Road, Dexter, Oregon 97431 County:Lane <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 in:cludin <br /> New location: 120 E. Sorbin Ave Gates Or. 97346 County: Marion <br /> ❑Dealer lot Dealer name: NA Dealer license number:NA <br /> ❑Park name(if applicable): NA - <br /> Out-of-state/federal or tribal property location: <br /> Current owner names; <br /> Carrie L.Wagner <br /> Are you changing the name of an existing owner? ❑Yes 0 No <br /> Changing from: to: <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? ❑Yes [I No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer throught <br /> divorce trus i t of survivorshi Yes ■ No If yes, attach Change Affidavit <br /> 'or rp? ❑ (Form 5221) <br /> BUYER/NEW OWNER NFORMAT1ON (one nam4 per box) :: , :..: ;. - • <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,frst, middle): <br /> Courtney, Mark <br /> Mailing address: Mailing address: <br /> 120 E. Sorbin Ave Gates Or 97346 <br /> 1 2 <br /> Phone number: Phone number: <br /> 5039102330 <br /> Email address: Email address: <br /> Bankit2@hotmai1.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 /> El Same as above 0 Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) Page 3 <br />