HomeMy WebLinkAboutBLD1990-00330 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account 11
PP Account 41
DATE :31/7l '?)
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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 inquen.t__ State transfer
by sale for title taxes report
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MOBILE HOME OWNERSHIP/OCCUPANT DATA
Name(s) ftt' I ,�S 141 t►--"C
Street or Box r LJ �1 5.�cJ
City ef) ime/Lum State/Zip
Home phone Work phone '
Best time to call
(specify home or work)
NOTE: If you -nt the mobile home give name, address, and telephone number of
owner here
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MOBILE HOME DATA:(exc
lude /l)I
Lengthclude hitch) �'t"1-1 Width Q eS Model Year Ck)
(n� Q
Make 0 C_ri" Model
Serial number
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MOBILE HOME •CATI' - IN PARK
Park name V
#Space Date placed in park
P .►
(PLEASE COMPLETE REVERSE SIDE)