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CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> Current location:15182 French Prairie Rd,Woodburn OR 97071 County:Marion <br /> 0 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: Sci G) iL ��wr ��q oils County: Icif!o.•, <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: Mary J.Nibler Living Trust <br /> Christine M.Welch and Jack N.Belleque Successor Trustees <br /> Are you changing the name of an existing owner? EI Yes ❑No <br /> Changing from:(�ctTJ , l ��= Ito: �Zel <br /> ESy , ,nr44 �Z ( > r <br /> Home transfer by inheritance? ❑ Yes elklo If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes iltai No If yes,attach Abandonment Affidavit(Form 2951) <br /> If yes,attach Change Affidavit <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes [d No (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 /> Coleman Real Estate Group,LLC <br /> Mailing address: Mailing address: <br /> 4494 Raybell Road NE <br /> 1 St Paul,OR 97137 2 <br /> Phone number: 503-932-1.554 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 /> 3 4 <br /> 0 Same as above ❑Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) Page 3 <br />