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Current location:2445 Pacific Blvd. SW Albany, Or 97321 County:Linn <br /> Dealer lot Dealer name: Dealer license number: <br /> 11 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: • <br /> rrt:'0,i0tkAtole... P-1,S`ot:svnv;'d <br /> New location:213 Wildw:Ood Ave...14141=Ra, Or 97350 County:Marion <br /> 0 Dealer lot Dealer name: Dealer license number: <br /> 0 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> ' =4'4, •". <br /> '1;117?"? ViA <br /> Current owner names: J M Homes, LLC <br /> Are you changing the nae of an existing owner? Ill Yes E No <br /> Changing from: to: <br /> Home transfer by inheritance? Yes j 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? 1:1 Yes 1E1 No If yes, attach Abandonment Affidavit(Form 2951) <br /> If yes, attach Change Affidavit <br /> Home transfer through dilvorce,trust,or right of survivorship? Yes El No <br /> (Form 5221) <br /> Buyer/new owner name (Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> Emery,Janice <br /> Mailing address: / Mailing address: <br /> —21-3-Witdwoocf-Avff. <br /> 1 *--tcfah-Frar-Q97350 .7(19 2/-6.., 041.Z.:?'-‘)/< <br /> 2 <br /> Phone number: : Phone number: <br /> 503-476-6086 <br /> Email address: Email address: <br /> • janz15@msn.com <br /> • Buyer/new owner name(Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> Mailing address: Mailing address: <br /> 3 <br /> 4 <br /> 0 Same as above , 0 Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) • Page 3 <br />