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<br /> i-'14: ::ReglICI 4 :'7'ffifrupg*TitotwogiffiAlloillk(f f iclutilnolcitylkftter
<br /> 1 cutivnt location: S5g County:- _...,.. ,,r ,r
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<br /> 0 Dealer lot Dealer name:
<br /> Dealer license number: ,
<br /> 0 Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> New location: / ,0 Fron .., . N, DA.,Fori_ O( 9-73 4 )• county: ayi•
<br /> 0 Dealer lot Dealer name:
<br /> Dealer license number:
<br /> 0 Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> d :+7, ,, ,f,:"iy.'a7=Vy
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<br /> Cument owner names: v C.
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<br /> Are you changing the name of an existing owner? 0 Yes 25 No
<br /> Changing from:
<br /> to:
<br /> Home transfer by inheritance? 0 Yes 1-23 No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? 0 Yes 2 No If yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer through abandonment process? E3 Yes g]No If yes,attach Abandonment Affidavit(Form 2951)
<br /> Home transfer through divorce,trust,or right of survivorship? 0 Yes 0 No If yes,
<br /> ;22171)1 Change Affidavit
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<br /> .,.._- 'd `" ziA ::`,13`,.' ER INFORMATION Ifiiiiitilatirblix.,:..,..y. z.$414-•—.1„..,44 ,,_'•%.„•::
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<br /> Buyer/new owner name(L art,first, middle): Buyer/new owner name(Last,first,middle):
<br /> ilaWes Edson E,,4,,, - A
<br /> -
<br /> Mailing a. ; .-,-s: 0
<br /> Mailing ad 0 ress;
<br /> 5As- &ice •-•<-4' • S • 6-02 s-- z3 o, ___ ..5,--/- •...0 •
<br /> &tern oe # , 02..._ satenAlok 973oz_
<br /> Phone number: 503-3 9 - 6 33 a Phone number: 60.3....85,9 _o 3
<br /> Email address.
<br /> Email address:
<br /> In.‘cAL3en g CoVrICASA".Iek
<br /> Buyer/new dl -1—
<br /> owner name aast,first,middle): Buyer/new owner name(Last,first,middle):
<br /> Mailing addreis:
<br /> Mailing address:
<br /> 0 Same as above
<br /> 0 Same as above
<br /> Phone number:
<br /> Phone timber;
<br /> Email address:
<br /> Email address:
<br /> 440-2952(7/17/COM)
<br /> Parte 3
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