HomeMy WebLinkAboutBLD1991-00634 OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account #
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) mar ,ce ci
Street or Box 6 0 pit
City 60 401,01 S-erci State/Zip
Home phone 38 3 (0 3 Work phone ' 3 - /
Best time to call /2 'QD N°U/.
(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) ,S.S Width l ® Model Year 19
Make Model
.
Serial number
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MOBILE HOME LOCATION - IN PARK
Park name
Space # Date placed in park
(PLEASE COMPLETE REVERSE SIDE)