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CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> 'Currentlocation:26976 S HWY 213 Mulino OR 97042 County:Clackamas <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 (including city, state, ZIP) . <br /> New location:3343Brown Rd NE Salem OR 97305 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 /> OWNER <br /> Current owner names: <br /> Teresa Marie Harrison Marie Teresa Steinbock <br /> Are you changing the name of an existing owner? ❑Yes Q No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes Q No If yes, attach appropriate Inheritance Affidavit(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 0 No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? IllYes Q No If yes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner name (La ,first, middle): Buyer/new owner name (Last,first, middl): <br /> Oar-to Sand CZ 6u, ai Tj 'e <br /> Mailing address: Mailing address: <br /> 1 3 341 '1100 °1 2, g ��lh�i <br /> ORCr- S <br /> 5�, , q 3 <br /> Phone number: Cr,/ I• .256ee Phone number: 56=3 - 5/ 7 • 3geeq <br /> Email address: jai/t✓----feLthllie t 7 Email address: e / le.( %6. _es E.,,//E.1, <br /> G /C/l e/en • ' a7/�,.,7 <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(7/19/COM) Page 3 <br />