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J 7 <br /> 1317298 <br /> CURRENT LOCATION INFORMATION (including city,state,:ZIP) <br /> Current location: 0. L.,1,44 .t b„,,, 1V� bt,„, h County: <br /> 0 Dealer lot Dealer name: Dealer license number: <br /> 0 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED, LOCATION CHANGES (including city,state,ZIP);° <br /> Newlocation: . <br /> 2 5k 4A'6,/J Cc�t (7.Y2 r -7 oo 2 County: r,0u <br /> 0 Dealer lot Dealer name: Dealer license number: <br /> Li 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? 0 Yes "o <br /> Changing from: to: <br /> Home transfer by inheritance? 0 Yes n No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? 0 Yes No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? 0 Yes G21No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? 0 Yes No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER.INFORMATION (one name perbox). <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first,middle): <br /> Mailing address: Mailing address: <br /> 1 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 /> 3 4 <br /> Same as above 0 Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) <br /> OR Title Application-10/2018-TitleApp11211 Page 3 004128728-00002 <br />