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1353699 <br /> L ' r * ` tW'; UO E� okt z ° rioo,S•. 1 4' <br /> Current location: -2,4 l7 i[G 1 C` « OIL q7.3.2.2_ County: y <br /> (� Dealer lot Dealer name: Dealer license number: <br /> Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> New location: q'777 -P�lT�rJj SEAL4,, a; Ile Celt_ G"1325 County:Rra4 bp j <br /> Ej Dealer lot Dealer name: Dealer license number: <br /> Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> o1ER <br /> Current owner names: <br /> Are you changing the name of an existing owner? El Yes'J No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑Yes No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ID Yes ®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? Yes n No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATI SN,(one najne per box. <br /> Buyer/new pwner name (Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> f C / KA-R car..} <br /> Mailing address: Mailing address: <br /> 9777 •sv;l?tQR473zS 2 <br /> Phone number:'b ?� 9 40-1-2)-) 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 /> 0 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-10/2018-TitleApp11211 Page 3 004222708-00001 <br />