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02/14/2014 10:26PM 7653810935 PAGE 02/04
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<br /> Current location:2540 AUSTIN RD. ROSEBURG,OREGON 97471 County:DOUGLAS
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<br /> ❑Dealer lot Dealer name: Dealer license number:
<br /> ❑Park name(if applicable): -
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<br /> Out-of-state/federal or tribal property location:
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<br /> - • New location:330 DETROIT RD S. DETROIT, OREGON 97342 County:MARION
<br /> • • ❑Dealer lot Dealer name: , 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: •
<br /> JUDY LEE REED
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<br /> Are.you changing the name of an existing owner? ❑Yes ❑t 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 Q No If yes,attach Abandonment Affidavit(Form 2951)
<br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes No If yes,attach Change Affidavit
<br /> (Form 5221)
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<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> • RASMUSSEN,JOHN RASMUSSSEN, MIRIAM
<br /> . Mailing address: Mailing address:
<br /> 339 E.VIEW LANE . 339 E.VIEW LANE
<br /> 1 • SILVERTON,OREGON 97381 2 SILVERTON,OREGON 97381
<br /> Phone number: • Phone number:
<br /> : 503-789-0822 ® .
<br /> Email address: Email address: •
<br /> jm.boatn@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 ❑_Sarrie as above
<br /> Phone number: Phone number:
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<br /> Email address: : Email address:
<br /> 440-2952(7/19/COM) Page 3
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