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CURRENT LOCATION INFORMATION (including city, state, ZIP) I <br /> Current Iocation: 1. 3C 2.. Hi Z Ice- 1- Lt. 4 rSi Ivr-rTc%_,„_ C G Z3,81 County: Pyle ri c,iw I <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 /> L New location: .�` LeNA 7.:,c, azt-- ct ,s {�`Q (17;4ft <br /> County: 0r-1 <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: <br /> Akel Lit- <br /> Dcrv-y_s t j_ _ � i �_ <br /> Are you changing the name of an existing owner? []Yes Q No <br /> Changing from: to: <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 0 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? ❑Yes 0 No dyes, attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION(one name per box) <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name (Last,first, middle): <br /> ?± S\-- c e l yk CWANI-7\-->F's irs'eI___, . <br /> Mailingaddress: I Mailing address: <br /> (? . ce. Si <br /> Phone number: Phone number: <br /> 50-3--9-79? --5-7e,C cog 5C3aLl <br /> Email address: Emai(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 /> 0 Same as above <br /> Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7.f 19;COM) Page 3 <br /> Z'd 66Z 1-OOZ-£09 eolrueg ewoH eligow s6noa d6Z:ZO 'OZ 0£oea <br />