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1415885 • <br /> CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> Current location: � CP1r,,ty t t\-A Nt Q Qqt I County: <br /> nYA0 Dealer lot Dealer name: l Dealer license number: <br /> 0 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED, LOCATION CHANGES (including city, state,ZIP) <br /> New location: \q5 prf e_. County: <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 /> OWNER <br /> Current owner names: <br /> Are you changing the name of an existing owner? Yes 0 No <br /> Changing from: to: <br /> Home transfer by inheritance? 0 Yes No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? 0 Yes 0 No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? Yes 0 No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes 0 No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner na (Last,first, middle : Buyer/new owner name(Last,first, middle): <br /> Johnson Donnie — ? � Johnson Brenda <br /> 'JO/Lk/50n #J C•t=4?1ST <br /> 1 Mailing address: ) x. Lio ,/ Mailing address: 2(3 b `/ <br /> f cr4 - f)r .i =L J 2 { r-;1. Ci (-.q/ <br /> Phone number: 503 557 , -/-" /5 Phone number: 50 3 5 5 ct - /6q 0 <br /> Email address: ego 6re3- �C�n.�7 rc? Email address: `t/6?- Q. 6 reici. c�M ((q/O <br /> cj mit/ <br /> r n 1 0 �c YYti <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 0 Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) <br /> OR Title Application-10/2019-TitleApp 11211 Page 3 <br /> 004414866-00001 <br />