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1339266 <br /> CURRENT LOCATION INFORMATION(including city,State,ZIP) <br /> Current location: ay4/5 5W i:4L► hhivdftibiAt, t 8734 County: <br /> 0 Dealer lot Dealer name: /^ a /_n ',tome ' Dealer license number: <br /> l� t� rAl 55-76 <br /> 0 Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> i BEING MOVED,LOCATION CHANGES(including c;tai;s es II).. <br /> New location: `15-18 mo tAt'14" Arlt 1 No,/ 1,\J E 5i►VN411 o `?i&i County: /dais an <br /> Dealer lot Dealer name: Dealer license number: <br /> [l Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> OWNER <br /> R <br /> Current owner names: <br /> Are you changing the name of an existing owner? 0 Yes El No <br /> Changing from: to: <br /> Home transfer by inheritance? 0 Yes�No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? L J Yes o If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? 0 Yes " No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? 0 YesEiNo If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION(One name per box) <br /> Buyer/newowynrer name Last,first, middle): Buyer/ ewow,ner name(Last,first,middle): <br /> !' 1Ut,(.✓ iG f-iAt+t// .ri4 <br /> Mailing address: ea% Mailing address: <br /> 1 7.576 AlaKrAl Anyi Hwy ic: ."` ldtdefrl 012 2 776 /40447 I tiw 4 AO t*-44 D . t 7j <br /> Phone number: 5'61 774 16 Phone number: �,?T5, 9Q9 <br /> k <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 <br /> 004186045-00002 <br />