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f ti <br /> 1439195 <br /> CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> Current location: 144 5 SW -N16.; C t r_ 4i Ln y ()f County: t,,; <br /> Dealer lot Dealer name: 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: Z 7 5 Hill .SJ-.S N -re:t q7 3'147, County: Mar►d(t <br /> 0 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? 0 Yes No <br /> Changing from: to: <br /> Home transfer by inheritance? 0 Yes /JNo If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? 0 Yes.2rSlo If yes,attach Affidavit of Repossession(Foran 3926) <br /> Home transfer through abandonment process? ❑Yes 2110 If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? []Yes,'No If yes,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 /> Bruce Robert Alberts Tammy <br /> Mailing PO x ��, F7a <br /> G cl 734 . 2 Mailing address: boat R q,�3c-Ia <br /> 1 address: �e;�fa:�- -� 0 <br /> Phone number: S epo I�7..S Phone number: 503- S. €1124 <br /> Email address: V,r•"c,4.6 o b �� Email address: 11 c..b go-rossc( - <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 [] 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-TitleApp11211 Page 3 004426479-00002 <br />