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CURRENT'LOCATION INFORMATION (including city, state, ZIP) <br /> Current location: Lt. L j cr r C 5 7_ f/ . County: <br /> ❑Dealer lot Dealer name: Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF:BEING.MOVED, LOCATION CHANGES (including city, state, ZIP) <br /> 7 New location: I 5 11 L 0000 � .;T r , O R 11-73qq County: fig ittri OvN <br /> ElDealer 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: R t o_n S n o <br /> Are you changing the name of an existing owner? ❑Yes [1.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? 0 Yes ®No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes [N No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ElYes [No 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/ne owner name(Last,first, middle): <br /> TPt5 PlAi -e-- , <br /> Mailing address: Mailing address: • <br /> 1 <br /> P.O. boy: tC� d-; Truer 2 <br /> Phone number: 6'2 3 Phone number: <br /> Email address: Email address: <br /> r iii Qd�tSLq� ryipt; l ,Cam", <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(7/19/COM) Page 3 <br />