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• <br /> C_ ATION <br /> c � SdINFORMATION'(Incuding.Pity,sae;Z <br /> Current Ideation: 1, f ( _5 1P) <br /> County: NA6.44 <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> y , iF;BEIN �1 OVED,:LOCATION CHANGES Iriclud(hg city,;state ZIP) , <br /> X New location: rz; 7/Y A -P � 7 ,,10/272:371 County: - <br /> ❑Dealer Iot Dealer name: 5 Ip N �a���; c_ Dealer license number. <br /> ❑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? []! Yes ❑No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑Yes 0 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 !]No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? 0 Yes 0 No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEWOWNER:INFORMATION(one'name per boxy <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first,middle): <br /> livrcOf 0 U\ <br /> Mailing addrelts: Mailing address: <br /> VO 2301- 1-N31 <br /> 1 Mokaalk, gyg �i1o3$ 2 <br /> Phone number: Phone number: <br /> 503— x-}22 8 I (02. <br /> Email address: Email address: <br /> WV\ Sr ,YiCC1z E ck110:1..CO len <br /> Buyer/new owner name(Last,first, mid e): • Buyer/new owner name(Last,first, middle): <br /> Mailing address: Mailing address: <br /> 3 4 <br /> 0 Same as above ❑Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2932(7/17/COM) page 3 <br />