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<br /> Current location: 550 SW BOOTH BEND ROAD County: YAMHILL
<br /> ❑■ Dealer lot Dealer name: FACTORY EXPO HOMES Dealer license number: MSS382
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> New location:4613 Briar Knob Loop Scotts Mill OR 97376 County:Marion
<br /> ❑Dealer lot Dealer name: Dealer license number:
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> Current owner names: Factory Expo Homes
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<br /> Are you changing the name of an existing owner? ❑Yes 0 No
<br /> Changing from: to:
<br /> Home transfer by inheritance? ❑ Yes 0 No If ye4, attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? ❑ Yes 0 No If}les, 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
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<br /> Buyer/new owner name(Last,first, middle): I Buyer/new owner name(Last,.first, middle):
<br /> Beard, Rex, Lee I Hernandez-Beard, Joyce, L
<br /> Mailing address: Mailing address:
<br /> 6970 SW King Blvd.Apt. 13 6970 SW King Blvd.Apt. 13
<br /> i Beaverton OR 97008 2; Beaverton OR 97008
<br /> Phone number: Phone number:
<br /> 503-521-6774 1 503-521-6725
<br /> Email address: I Email address:
<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> Mailing address: Mailing address:
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<br /> ❑ Same as above ❑Same as above
<br /> Phone number: Phone number:
<br /> Email address: 1 Email address:
<br /> 440-2952(7/17/COM) P4ge 3
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