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1519917 <br /> CURRENT LOCATION INFORMATION (including,city,state,ZIP) <br /> Current location: 3 7 6,„I rY br. 4 E A 16ew y 0 R q 73 2 a County: L; n <br /> Er Dealer lot Dealer name: Clew <br /> � 140on es 41 b n Dealer license number:M s ! y s <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 /> New location: G-3 Z j. ��, Si!t,„ ,-to n� o Ct 73 k i County: ik, ®f, <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? Yes Q No <br /> Changing from: to: <br /> Home transfer by inheritance? Yes 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? El Yes No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? El Yes Ej 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 /> Linhart Michelle <br /> Mailing address: a l l S $U."*Nfift vs %Jo b Mailing address: <br /> 1 S�w,�hvn or q1 ,2 2 <br /> Phone number: CO3 S S of 72 5 7 Phone number: <br /> Email address: K;.- $1 ,ti,;Gh G I I e @}, ap l.c.c,f. 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) <br /> OR Title Application-10/2019-TitleApp11211 Page 3 004733163-00003 <br />