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1504858 <br /> CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> Current location: 1437 d:ut County: L i v,r® <br /> Dealer lot Dealer name: efriltIon dt Dealer license number: <br /> 1101 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:451 l( P c- be i( tsr. S E so,I / 0 e q 7 o County:./14 r1 <br /> El 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? E Yes No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑Yes Ei No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? C Yes El No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? Yes No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ElYes Q 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 /> Machado Sylvia <br /> Mailing address: LISj4I r L�{l br°, S 5 Mailing address: <br /> 1 Sale , U 2 a71 o 2 <br /> Phone number: CI'xl 6 I ®1 of .Phone number: <br /> Email address: l c c(y CA("do ��1;0 e 1.Cony. 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 /> 11 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-TitleApp 1121 l Page 3 004663098-00003 <br />