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CURRENT LOCATION INFORMATION (including city, state,ZIP) <br /> Current location:,,3 7 ,�red 2 dvey his �E t,,�/ County 6r ,� v <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> [<Park name(if applicable): A p ed v i w 0 G,,j °E6-760-as <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED, LOCATION CHANGES (including city, state, ZIP) <br /> New location: X1300 ClpvQd-cla_te, County:1Wcu <br /> ❑Dealer lot Dealer-name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> OWNER <br /> Current owner names: <br /> utc5g) <br /> Keit <br /> Are you changing the name of an existing owner? ❑Yes ENo <br /> Changing from: to: <br /> Home transfer by inheritance? 1Yes ❑No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑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. es ElNo If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name per box) <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> Mailing address: - Mailing address: <br /> S1/4.,.: l33°'��4✓� <br /> 1 1Aeo- , ore._ cl i —4 2 <br /> Phone number:• 703 SI tc, (pgVA Phone number: <br /> Email address: KQ-.'e KA-KA/LOA 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 ❑Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/19/COM) Page 3 <br />