HomeMy WebLinkAboutBLD1990-00192 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account #
PP Account #
DATE v 70
Please read the entire form and provide as much information as possible. This will
help us identify the unit correctly and avoid double assessments. It will also aid
in placing a correct value on your property.
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REASON FOR INQUIRY:
Field visit Excise tax Building Moving
by deputy affidavit permit permit
Dealer report Application Delinquent State transfer
by sale for title taxes report
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MOBILE HOME OWNERSHIP/OCCUPANT DATA
Name(s) / 0 . �1 O C a
fi
Street or Box STD) H a,
City ) State/Zip
C�
Home phone 3�J — Work phone --a C
:)
Best time to call
(specify home or work)
NOTE: If you rent the mobile home give name, address, and telephone number of
owner here
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MOBILE HOME DATA:
c/I
Length (exclude hitch) Width Model Year /
Make �� Model
Serial number
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MOBILE HOME LOCATION - IN PAR
Park name
Space I Date placed in park
(PLEASE COMPLETE REVERSE SIDE)