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• <br /> CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> • Current location: CA 1(011N N\f6 y ska A. County: saoj <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 /> New location: 36C. t-os--c �W n ?� �e `�.1,6l\ (17143S County: )rU <br /> � e <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 /> RS-IQ 011.4)DI LUC. • <br /> Are you changing the name of an existing owner? n Yes - No <br /> Changing from; to: <br /> Home transfer by inheritance? ❑ Yes rg No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? n Yes ig No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? n Yes X1No If yes,attach Abandonment Affidavit(Form 2951) <br /> If <br /> Home transfer through divorce,trust,or right of survivorship? Yes ®No 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 /> CAZ'Y E <br /> Mailing address: Mailing address: <br /> 1,©R "t143c 2 <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> Mailing address: Mailing address: <br /> • <br /> 3 4 <br /> ❑ Same as above n Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) Page 3 <br />