Laserfiche WebLink
z roi1iYRENTrLOCATIQN INFORMgi.Citd(ncluchi city,state'gIP)r <br /> S-5C� c,•;-1 �6 County: t-t(�,YYk�'tr�l <br /> Current location: fir^ miv,r\1‘ r`,CZ L-1.-1 ' <br /> Cl Dealer lot Dealer named Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> `LO ATION CHANGES`„(trtetuding. 1 stat <br /> New location: s--fl3 UY\S1t1t1vE( Jp r HiLLIOI County:rd.97/532_ man on <br /> El Dealer lot Dealer name: Dealer license number: <br /> El Park name(if applicable): t`1'0 odV 1e ) sey6 C r g-Sit” e <br /> Out-of-state/federal or tribal property location: <br /> Current owner names: <br /> Are you changing the name of an existing owner? ❑Yes Q No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑Yes Q No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes Q 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 /> If yes,attach Change Affidavit <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes 0 No (Form 5221) <br /> z t wt" ' s t `,3 BUYERINEW OWNER INFORMATION(orae name'per box) <br /> 'Buyer/new owner name(Last,first,middle): Buyer/new owner name(Last,first,middle): <br /> FULLER,RICHARD C FULER,VIRGINIA J <br /> Mailing address: Mailing address: <br /> 31-1 <br /> 1 tr a )^bc1 rCit O ct`I O32. 2 <br /> Phone number: Phone number: <br /> 503. 3Z 9 . �0 33 <br /> Email address: Email address: <br /> Buyer/new owner name(Lass,first,middle): Buyer/new owner name(Last,first,middle): <br /> Mailing address: Mailing address: <br /> 3' a' <br /> ❑Same as above Cl Same as above <br /> • Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) Page 3 <br />