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• <br /> CURRENT LOCATION INFORMATION (including city, state, ZIP) <br /> / r y s�,� Cunt <br /> Current location: _ ���fv /-��U l74w Y:Zfj'JV C <br /> Q Dealer lot . Dealer name: <br /> Dealer license number: <br /> i] Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED, LOCATION CHANGES (including city, state, ZIP) <br /> New location: 727174 he,7_ ,j y ,,-F „5 ,�,63 . County: AketA <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: I/Vl Itru �S <br /> Are you changing the name of an existing owner? ❑Yes ®No <br /> Changing from: to: <br /> Home transfer by inheritance? ❑ Yes 74.No If yes, attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? ❑ Yes 0 No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? ❑Yes [C No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? ❑Yes g 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/new owner name(Last,first, middle): <br /> \ uP SO5`i Q , C1tea\ <br /> Mailing address: Mailing address: <br /> 11A.i 7'2,7 4-k1 l.o - 'g-1)St ew4 <br /> Phone number: 9..�1 20,_EO 2,9 Phone number: <br /> Email address: // Email address: <br /> Buyer/new owner name (Lalt,first, middle): Buyer/new owner name (Last,first, middle): <br /> Mailing address: Mailing address: <br /> 3 4 • <br /> D 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 /> Z'd 66Z 67OOZ-E09 Gown awoH ellgow s6no4 d017:170'OZ 90"0N <br />