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CURRENT:LOCATION INFORMATION'(including city,•state,:ZIP) <br /> Current location: 22823 N. SANTIAM HWY SE. LYONS, OR 97358 County: MARION <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> IN Park name(if applicable): N/A <br /> Out-of-state/federal or tribal property location: <br /> : IF BEING MOVED,:LO:CATION°CHANGES:0006441g:city state;:ZIP).: . I <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 /> OW <br /> Current owner names: EVELYN MOORS <br /> Are you changing the name of an existing owner? ❑Yes 0 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 0 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 Q No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWN R,INFORMATION (one name per box) . <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> le): <br /> MOORS, EVELYN <br /> Mailing address: Mailing address: <br /> 22823 N.SANTIAM HWY, <br /> 1 LYONS, OR 97358 2 <br /> Phone number: Phone number: <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 /> • <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 />