HomeMy WebLinkAboutBLD1990-00819 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE.
RP Account 4l
PP Account #
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 DATA
Name(s) c /0 cl r1� �
Street or Box it m /g uci
City N' (1 (n-O ct)(?-,State/Zip
Home phone , ,5=s - -2- -to 3 Work phone '
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: t
Length (exclude hitch) 4t C idth 2- � Model Year ck!)
Make - Gd"i7 odel Ai( A( S (kJ o od
Serial number
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MOBILE HOME LOCATION - IN PARK
Park name j
Space # Date placed in park
(PLEASE COMPLETE REVERSE SIDE)