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<br /> Current location:550 SW BOOTH BEND RD MCMINNVILLE OR 97128 County:YAMHILL
<br /> 0 Dealer lot Dealer name:FACTORY EXPO Dealer license number:MSS382
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property.location:
<br /> New location:4940 SUNNYSIDE RD SPC B6. SE SALEM OR 97306 County:MARION
<br /> ❑Dealer lot Dealer name: Dealer license number:
<br /> El Park name(if applicable):SUNNYSIDE
<br /> Out-of-state/federal or tribal property location:
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<br /> Current owner names: CORA HYATT/SUSAN CONOVER
<br /> Are you changing the name of an existing owner? ❑ Yes 0 No
<br /> Changing from: to:
<br /> Home transfer by inheritance? 0 Yes ■❑ 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? ❑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 /> HYATT, CORA MAE
<br /> . Mailing address: Mailing address:
<br /> 5345 NORMA AVE SE SALEM OR 97306
<br /> 1 2
<br /> Phone number: Phone number: _
<br /> 503-508-8989
<br /> Email address: Email address:
<br /> Buyer/new owner name(Last,first, middle):_ Buyer/new owner name(Last,first, middle):
<br /> CONOVER, SUSAN RAE
<br /> Mailing address: Mailing address:
<br /> 5345 NORMA AVE SE SALEM OR 97306
<br /> 3 4
<br /> ❑ Same as above ❑Same as above
<br /> Phone number: - Phone number:
<br /> 503-551-5291
<br /> Email address: Email address:
<br /> 440-2952(7/17/COM) Page 3
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