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1272788
<br /> V � .g f N OVISMILO MOI INFO MA attinellaili c�a to.; tR}, M
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<br /> Current location: County:
<br /> Dealer lot Dealer name: Dealer license number:
<br /> Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
<br /> g ,f ' MBtIf O KtMt CV ON ,OWMIM xn!ding cih%l fnigf ; S,SS
<br /> New location: j e 3
<br /> �-�' (a2 ,�� Sam-+ o� qq�� county: .M ,riU,,,
<br /> Dealer lot Dealer name: Dealer license number:
<br /> Park name(if applicable):
<br /> Out-of-state/federal or tribal property location:
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<br /> .h. :..�,..,hi'°s,�.i�.<fi;�a4' r..�._ ,e" .:.rd�.�+.�Fr;.o:...�h.�rcV'�..,.fin-u:, ,.,.',.. .,,_....'-.'7�aT.��'�'-��€��GaS£e,.'�•.,.��.,;��:.'•.ra?i_.<�r.'z - .#_�5?�,+'_.1` _
<br /> Current owner names:
<br /> rt_
<br /> Are you changing the name of an existing owner? Yes No
<br /> .�F. Changing from: to:
<br /> 171
<br /> s
<br /> Home transfer by inheritance? ['Yes ONO If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177)
<br /> Home transfer due to foreclosure? ['Yes El-No If yes,attach Affidavit of Repossession(Form 3926)
<br /> Home transfer through abandonment process? Yes 2No 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 /> r-•y Yom.. -g � '�-". v < '8`-k'�^v,�3:t+�4 't2_u:.x E+5�+.`-4.J��ct.'i r� t:,.,� ntu"ft .�.Y'.
<br /> aZ'f 861VYgL/ i.9.Q1f 1 ER,�INEOR itrejl�(gn me per oxo MSM-t «mss ',�:
<br /> Buyer/new owner name(Lag first, middle): < Buyer/new owner name(La t,first, middle):
<br /> Mailing address: Vri 3 Ng -c'a,00c=e 0r- Mailing address: 2493 006 ,r o ( Of.
<br /> S0,1e,r, oi{ 49-305 5a1.641 OR 611305
<br /> Phone number: Lilo_ 22 Z - Ivy Phone number: ��, 8�Z _ 3Liy
<br /> Email address: dpe.11t da,_ Cin, 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(7/17/COM)
<br /> OR Title Application-12/2017-TitleApp11211 Page 3 004021600-00002
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