Manufactured Home Rendition
Manufactured Home Personal Property Exemption
Complete this section ONLY if you no longer OWN the manufactured home you owned last year
Form 935-MH
Page 2
A separate rendition form must be led on each manufactured home: Each manufactured home is assigned an account number, if
you own more than one manufactured, please be sure to match the manufactured home to the assigned account number on the form.
If you no longer own this manufactured home: A manufactured home that has been sold, traded, repossessed,
destroyed by re, ood, etc., please provide the information requested below in order to avoid possible incorrect or
duplicate assessment and tax liens.
To move or change ownership: A 936-R Form must be obtained from the County Assessor. The Department of Public Safety will not
issue a moving permit without this form and current year decal, nor will a title be transferred without this form. This is a requirement to
verify that all manufactured home taxes have all been paid.
To obtain a 936-R Form contact the County Assessor’s ofce in the county where the Manufactured Home is located, and provide the
following information:
To Move - The old and new address and either the name of the land owner or Manufactured Home Park. The taxes for the entire
current year must be paid.
To Change Ownership - New owner’s name and address and either the land owner or Manufactured Home Park name where the
Home will be located. The taxes for the entire current year must be paid.
Is this mobile home your principal residence?...................................................................... Yes No
Were you living in the home January 1st of this year? ......................................................... Yes No
Do you own land where the manufactured home is located? ............................................... Yes No
If YES: Closing Date: ______________ Book Number: ________________ Page Number: _____________
Age 62 or older? ................................................................................................................... Yes No
Is your household income less than $22,000 or 50% of the HUD Median Family
Income for your county? ....................................................................................................... Yes No
Contact your county assessor for the qualifying HUD income.
This Manufactured Home Was: Sold Repossessed Traded
Destroyed By: Fire Flood Other: _____________________________________________________
Date this Occured: ________________________ (Must have Month and Year)
Person or Company that Took Possession of Manufactured Home:
Name: _________________________________________________________________________________________
Address: _______________________________________________________________________________________
City, State, Zip: __________________________________________________________________________________
Your Signature as Former Owner: ____________________________________
If manufactured home was traded for another manufactured home, please furnish copy of title on new or used manu-
factured home and complete information requested below.
Location of Manufactured Home: ____________________________________________________________________
Street Address: __________________________________________________________________________________
Manufactured Home Park or Land Owner’s Name: ______________________________________________________
Your Phone Number: _____________________________________________________________________________
Manufacturer: ___________________________________ Model: ________________ Size: ________X ________
Identication Number: _____________________________ Title: _____________________ Year Made: ________
Factory Delivered Price ____________________ Year Purchased: _______ Purchase Price: _________________
Central Air: Yes No Deck: _____ X ______ Canopy: ______ X _______ Storage Bldg: ______X ______
