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5 <br /> CURRENT LOCATION INFORMATION (Including city, state, ZIP) - <br /> Current location: 2i y a LI � �n /J 7 7, County: <br /> �1+k7 rt�aR <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 /> 2( New location: 2 t7(�21 '4 ci 1 E A")rory, C)R, 61100 2 County: <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 /> Are you changing the name of an existing owner? ❑ Yes f:No <br /> Changing from: to: <br /> Home transfer by inheritance? Yes El No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes f No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑ Yes J No If yes, attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? 11] Yes Q NoIf yes. attach Change Aff davit <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,fust, middle): <br /> Ores\a(N Clowet'S, -Sac,, • <br /> Mailing address: Mailing address:nn <br /> OX 31\ AurOrck, 017.E C1 002 <br /> 1 2 <br /> • <br /> Phone number: _61e..2S$O Phone number: I� <br /> Email address: -El te;reorc 50"flow e_.r5, -"M Email 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 /> ❑Same as above ❑Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) <br /> Page 3 <br />