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• <br /> CURRENT:LOCATION INFORMATION (including city, state, ZIP) <br /> Current location: 22315 Jennie Road SE, Lyons, OR 97358 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 /> IF BEING MOVED, LOCATION CHANGES (including city, state, ZIP). <br /> X1.1 rteerma- <br /> New location: . t, Mehama, OR 97384 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: Jose F Cruz Alcantar <br /> Amy D Cruz <br /> Are you changing the name of an existing owner? ❑Yes n No <br /> Changing from: to: <br /> Home transfer by inheritance? n Yes ❑] No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? [' Yes 0 No If yes, attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? n Yes 0 No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust, or right of survivorship? II]Yes n No If yes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one nameper box) <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> O'Dell, Roberta <br /> Mailing address: Mailing address: <br /> PO Box 236, Lyons OR 97358 <br /> 1 2 <br /> • <br /> Phone number: Phone number: <br /> 503-580-8410 <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 ❑ Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> • <br /> 440-2952(7/19/COM) Page 3 <br />