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<br /> Current location: County:MARION
<br /> R]Dealer lot ` Dealer name:CASCADE FACTORY HOMES,INC. Dealer license number:MSD-41
<br /> D Park name(if applicable): .
<br /> Out-of-statclfcderal or tribal property location:
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<br /> New location:28 JUNIPER CIRCLE,WOODBURN,OR 97071 County:MARION
<br /> ❑Dealer lot Dealer name: Dealer license number:
<br /> ®Park name(if applicable):WOODBURN WEST MOBILE HOME PARK
<br /> Out-of-state/federal or tribal property location:
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<br /> Currojt owner names: CASCADE FACTORY HOMES,INC.
<br /> Arc you changing The name of an existing owner? jj Yes 0 No
<br /> Changing from:CASCADE FACTORY HOMES,f to:MARY ANN SELL
<br /> Home transfer by inheritance? 0 Yes ®No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer dile to foreclosure? []Yes d No If yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer through abandonment process? ❑Yes III No If yes,attach Abandonment Affidavit(Form 2951)
<br /> Home transfer through divorce,trust,or right of survivorship? El Yes ©No ryes,attach Change Affidavit
<br /> (Form 5221) •
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<br /> Buyer/new owner name(Last,first,middle): Buyer//•neve owner name(Last,first, middle):
<br /> BELL,MARY ANN
<br /> • Mailing address: Mailing address: •
<br /> '•' 27 JUNIPER CIRCLE
<br /> 1 WOODBURN, OR 97071 2 '
<br /> Phone number: Phone number': •
<br /> Email a.ddress; Email address:
<br /> . Buyer/new owner name(Last,first,middle): Buyer/new owner name(Last,first, middle):
<br /> I
<br /> Mailing address: • Mailing address:
<br /> .3 4
<br /> 0 Same as above ❑Same as above
<br /> ; PI:one number: - Phone number;
<br /> Email address: Email address:
<br /> 4404932(7II/10OM) Page 3 •
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