HomeMy WebLinkAboutBLD1990-00399 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account 41
PP Account 1/
DATE
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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 Delinquent State transfer
by sale for title taxes report
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MOBILE HOME OWNERSHIP/OCCUPANT
I DATA
Name JQI
s) . L`1 C- , l aka �I /`l CO L.6
Q
Street or Box r . F3 o /
City PU 11 [` P.rl e State/Zip Y qg 3 7 C
Home phone 7 5 3 55,j Work phone
Best time to call /s T 1 e -t • D c m
(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:
Length (exclude hitch) 1p Q / Width a.g Model Year )9 9 0
Make Ki Model C�U �� n l akE.
Serial number
**********i*lock *
MOBILE HOME LOCATION - IN PARK
Park name
Space # Date placed in park
(PLEASE COMPLETE REVERSE SIDE)