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CURRENT LOCA'TIO=N INFORM#ATION(mcluding city,state; ZIP), ; <br /> Current location:24445 Pacific Blvd. SW Albany, OR 97321 County:Linn <br /> ❑ Dealer lot Dealer name: Dealer license number: <br /> ❑ Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> f IF BEING MOVED, LOCATION:CHANGES (including city, <br /> New location:'21965 Camellia Ct. NE Aurora, OR 97002 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: J&M Homes, LLC <br /> Are you changing the name of an existing owner? ❑Yes ❑® No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes ❑m No 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 Q No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? 111Yes Q No If yes,attach Change Affidavit <br /> (Form 5221) <br /> zf • ,BUYER/NEW OWNER INFORMATION (one namelperEbox) <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> Garcia, Ruben Garcia,Sheri <br /> Mailing address: Mailing address: <br /> 21965 Camellia Ct. NE 21965 Camellia Ct. NE <br /> 1 Aurora,OR 97002 2 Aurora, OR 97002 <br /> Phone number: Phone number:. <br /> 503-678-2079 503-678-2079 <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 /> ❑Same as above _D Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) Page 3 <br />