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DocuSign Envelope ID:8B3B090D-DAE9-4ACB-A452-59AA00150A2E <br /> • <br /> 1448441 <br /> . CURRENT LOCATION INFORMATION(including,city,state,ZIP) 1 <br /> Current location:. l5,t, v c , <br /> X1 - 1 �72 <br /> I-County: - ... 1 <br /> ❑Dealer lot Dealer•name: .. I Dealer license number: . <br /> ❑Park name(if:app).icable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED,LOCATION CHANGES(including city,state,ZIP) <br /> New location: Nr. Q County: ,1 <br /> ❑Dealer lot Dealer.name: 1 Dealer license number: <br /> Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> OWNER <br /> Current owner names: <br /> Are you changing the name of an existing owner? ❑Yes❑No <br />• Changing from: to: <br /> Home transfer by inheritance? attach appropriate Inheritance Affidavit <br /> �Yes❑No If yes, (Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes Q No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes No I <br /> fyes,attach Abandonment <br /> Affidavit(Form 2951) <br /> Home transfer through divorce,orce,trust,or right of survivorship? Yes❑No If yes,attach Change Affidavit -� <br /> • <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new Yr/new owner name(Last,first, middle <br /> Crowder Susan ) Buyer/new owner name(Last,first, middle): <br /> Mailing address: PO Box 405 Detroit, OR 97342 Mailing address: <br /> 2 <br /> Phone number: 503=559-9791 Phone number: ~W <br /> Email address: sj c rowde r 54@gmai 1 .com 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/]9/COM) <br /> OR.Title Application-10/2019-TitleAppl121 I Page 3 <br /> 004499938-00002 <br />