|
•
<br /> DocuSign Envelope ID:F5840D12-9962-401C-A94C-90541DCDOF7C
<br /> rr'l v fpx4i i-1.** .i i.+:{1En ^`�` e 7.Zr :h: 1r:e arFtt.,r ,,,:,- 1( V A hn�rJ�.ws f iltr eK 1 se's-J �.,;t";c,t ;' .
<br /> ..f���,Nt�LCr3fs`,'��r t1r� RII�IFORIUI�`� Nr(1riCIi� y � �ZlP)� �� 'ra
<br /> Current location:2555 Progress Way,Woodburn, OR. 97071 County:Marion
<br /> ❑■ Dealer lot Dealer name:Factory Expo Homes Dealer license number:MSD 448
<br /> ❑ Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> X75 �tt�9 JK��r��r n'r�m �.. t.s r r •4�t ff`'y t! rx' IL f 'xl x Js acs Ayf<t a''� r�'.r"�r<< � - � �-.n rtiG.,y r { x+ -. x'"},
<br /> Pres �ligi irg:Wi O Opti�i,CFf1,1�110 ir�0ludm ;ci,ji. Esta el l.Pi. :E : "'�•J_� '�.
<br /> New location:13570_Wisteria Ct. NE,Aurora, OR. 97002 County: Marion
<br /> ❑Dealer lot Dealer name: I Dealer license number:
<br /> ❑Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> w yx � sed tr 3si e ,I fir3i.z 9ny�;"" d.f x--'`s ! 1, .sr ,,;,,Jz. y i-:. h rtz..,
<br /> �tt'ifr'_U..E�.f' t�.u, ,.x '}n. tr'; ��}� cf.�r Y -4Yir: Y �'£� zt rr�yrt i, `C G3 .,�.i i.�t?ft{ s,�^i�. A�- 1� �'' 1� �. ;t k"r c•+�;
<br /> `"V' tsA •r, 1 rr J' �S P 3�o�P J y �ark IY 7 S{,.Y QW A+{ '{ t,YFy * s r a1�SSS .r, Yf ^� Pel' ,T"' �' t h *x+4}
<br /> r, 5v l.I,.C7 iA r.. 7cr 'k V:,ri�igA•crV ��•fi:.r._ Y e r ev,?,•f..
<br /> Current owner names: Alta Cima Corp.
<br /> Are you changing the name of an existing owner? 0 Yes ❑No
<br /> Changing from:Dealei to:Owner
<br /> Home transfer by inheritance? ❑Yes Q No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? ❑ Yes UI No If yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer through abandonment process? ❑Yes n No If yes,attach Abandonment Affidavit(Form 2951)
<br /> If yes,attach Change Affidavit
<br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes 0 No (Form 5221)
<br /> '' rr ''y�P.1 JI.�,P3�Y/# ,1� � Y r ftntr7 Ay`)i%t Ze- � �.x 1r�t J,-�' et d 'S x'J,� '-f 7 y�..wy- -..J Rn(. 'T"Sx.y A t !,- 7f° Tf•`k'•�t^.,.,,�'•l.�. t
<br /> r y 1 l Cl„.- , W OVII �R IN IUfA`TIO V+;��ie nam per t ctx� � ��<° y
<br /> w t.R k ,..LJ/r.`„toKr:h fir•-.%Yy`^_�..ar,.k.Jix.....�.r.rF`.,fl f�+nleC,lkrt',r ..,...i i�l::.:?.?:.�.�;x..r... M.Gx}f t,�?f,_�:..., t r.. :.i...,.....t't.,;i.. w fi. s
<br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle):
<br /> Brumbaugh, Shawn R.
<br /> Mailing address: Mailing address:
<br /> PO Box 1
<br /> Beavercreek, OR. 97004 2
<br /> ' Phone number: Phone number:
<br /> address:Email Email address:
<br /> _
<br /> Buyer/new 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 /> 440-2952(7/19/COM) Page 3
<br />
|