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DotuSIgn Envelope ID:6288A8A9-9556-404€ 1-3195DED5F1E2 <br /> 1449988 <br /> CURRENT LOCATION INFORMATION(Including city,suite,ZIP) <br /> Cuaent I« ion: 2..0 u 1 ( t ^L""1,o kv 0 Rtryln c' -`119'2 Co nity: ( :Lli <br /> ADealer lot Dealer name: \Ckl -� \- m Dealer license number: <br /> Park name(if applicable): `i <br /> Out-of-state/federal or tile property location: <br /> IF BEING ROVED,LOCATION.CHANGES(Including city,state,ZIP) <br /> New location ' ) rt.()r ta- :3 ,1h . ._ ?l L j 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? El Yes®No <br /> Changing from: to: <br /> Home transfer by inheritance? [Yes[No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? Li Yes(]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? D Yes Q No If yes,attach Change Affidavit <br /> (Form 522I) <br /> BUYER/NEW OWNER INFORMATION(one name per box) <br /> Buyer/new owner name(Lack flrs4 middle): Buyer/new owner name(Last;first,middle): <br /> West Patrick West Vickey <br /> Marling address: LY-Ux 1 f A`31 o 6`l` t-.-a..CV- 2 Mailing address: '3 tL t 11 5 ton 1 5'C <br /> Phone number:a.35.10 U Phone number: 1 O i <br /> Email address: Email address: <br /> Buyer/new owner name('Last,flr4 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 /> 440.2932(7/19/OOM) <br /> OR ride Application-10/2019-TitleApp11211 Page 3 <br /> 00452695,400005 <br />