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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location:120 4TH St. Detroit, Or 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: <br /> • <br /> • IF BEING MOVED, LOCATION CHANGES (including city, state, ZIP) - <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 /> OWNER • <br /> Current owner names: J & M Homes, LLC <br /> • <br /> Are you changing the name of an existing owner? ❑ Yes n No <br /> • Changing from: to: <br /> Home transfer by inheritance? n Yes 0 No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Horne transfer due to foreclosure? ❑ Yes 0 No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑ Yes n No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ElYes n No If yes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) • <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first,middle): <br /> Rose,James M. Rose, Susan M. <br /> Mailing address: Mailing address: <br /> 120 4TH St. 120 4TH St.• <br /> Detroit, Or 97342 2 Detroit, Or 97342 <br /> Phone number: Phone number: <br /> 503-371-3938 © 503-371-3938 <br /> Email address: Email address: <br /> mikerose@rosepaper.com mikerose@rosepaper.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 /> • <br /> • 440-2952(7/19/C0M) Page 3 <br />