1) COMPLETE THE FORM BELOW WITHIN 14 DAYS

    Name
    Address
    City, State & Zip
    Email
    Date of purchase
    Purchase Price
    Location of mobile home:

    Prior owner's information

    Name
    Address
    City, State & Zip

    2)Date the mobile home was moved into Ellsworth

    Description of mobile home
    Year
    Length
    Width
    Serial Number

    If the mobile home is located on a private lot, please indicate the property owner's name and address:

    Name
    Address
    City, State & Zip

    PLEASE ATTACH A COPY OF THE BILL OF SALE TO THIS FORM WHEN SUBMITTED TO THE ASSESSORS OFFICE.