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I 1370817 CURRENT LOCATION INFORMATION (including city,state,ZIP) Current location: 17_157 c yr,5 Dr. K... A, 50 c1.73,Da County: u,A Dealer lot Dealer name: t OY\ VAC res Dealer license number:W/95— 0 Park name(if applicable): �" Out-of-state/federal or tribal property location: IF BEING MOVED, LOCATION CHANGES (including city,state, ZIP) New location: a 50,,,,,m4 oO r jU over pia R 7 qa County:rrari,on Q Dealer lot Dealer name: Dealer license number: 0 Park name(if applicable): Out-of-state/federal or tribal property location: OWNER Current owner names: Are you changing the name of an existing owner? 0 Yes,EN-o Changing from: to: - Home transfer by inheritance? 0 Yes?No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) Home transfer due to foreclosure? 0 Yes 7-No If yes,--attach Affidavit of Repossession(Form 3926) Home transfer through abandonment process? ❑Yes No If yes,attach---- fAbandonment Affidavit(Form 2951) Home transfer through divorce,trust,or right of survivorship? El Yes No If yes,attach Change Affidavit (Form 5221) BUYER/NEW OWNER INFORMATION (one name per box) Buyer/new owner name(Last, rst, mi le): , Buyer/new owner name(Last,first, middle): Straw Kennet r- i Straw Janet J ��--77 & 41 /: r a ,e -Le5" -kral van - ( Mailinggaddre s: Mailing address: 01/:, 1 //r1 ,'Y eW 5t - cke 2 //'/�' :%. i7Z 6/heap —/,,,ivi., ;Jrue t Phone number:S44'/ I/. 3 2. Z6 Phone number: ._.e-4,/(• 3 3 2s° 2 Email address: Email address: Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): Mailing address: Mailing address: 3 4 0 Same as above 0 Same as above Phone number: Phone number: Email address: Email address: 440-2952(7/19/COM) OR Title Application-10/2019-TitleApp11211 Page 3 004268572-00001