HomeMy WebLinkAboutBLD1990-00223 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account II
PP Account 1{
DATE 1/' I 9-(")
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
„„)
-P_erm.i t permit
Dealer report Application Delinquent
by sale for title q Statetransfer
taxes report
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MOBILE HOME OWNERSHIP/OCCUPANT DATA
Name(s) Jl� /cer N
Street or Box 3 f f D P R.
y�7 r�
City 1 d/� T pi 5 �'n( /� State/Zip er [f 3 GO,
Home phone?®G- 5 f 6'- ''f/oe. Work phone
Best time to call
(specify home or work)
NOTE: If your ent the mobile home give name, address, and telephone number of
owner here
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MOBILE HOME DATA:
Length
g (exclude hitch) Width ,02 f1 Model Year /
Make Model �[
Serial numb
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MOBILE HOME ' OCAT/ON - IN PARK
Park name
Space # Date placed in park
(PLEASE COMPLETE REVERSE SIDE)