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DocuSign Envelope ID:F22AB349-941C-4DB6-E =B46E3ADF062 <br /> 1397019 <br /> CURRENT:LOCATION_INFORMATION(includmp;'c1ty,,:state,ZIPS <br /> Current location:'q S ,2)�� County: b h <br /> 0 � `1►J�4.� <br /> Dealer lotU <br /> Dealer name: <br /> Dealer license number: <br /> ❑Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> 7F BEING•MOVED,.,LOCATION CHANGES(Including;city,;state,ZIPS, ,t <br /> New location: �2 'CtiU t tE� II us o1r„,ceg-Itz County: mar,on <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 /> Are you changing the name of an existing owner? ❑YesZNo <br /> Changing from: to: <br /> Home transfer by inheritance? ❑Yes7JNo If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑Yes ErNo If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? 0 Yes No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yeso If yes,attach Change Affidavit <br /> (Form 5221) <br /> ,BUYER/NEW OWNER INFORMATION lone name per:box). _ _. <br /> Buyer/new owner name(Last,first,middle): Buyer/new owner name(Last,first,middle): <br /> Hammersley Linda <br /> Mailing address: 3 -M ' ' t b i IV. Mailing address: <br /> 1 1 wr, re. 0 IZ e1100 2 <br /> Phone number: Phone number: <br /> Email address: L u ahn m Lr G.f./4.14r ,4 Evail address: <br /> Buyer/new owner name(Last,fast,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) <br /> OR Tide Application-10/2019-TitleApp 11211 Page 3 004324926-00001 <br />