MOBILE HOME PARK AND TRAILER COURT OPERATOR’S REPORT TO COUNTY ASSESSOR
NAME OF PARK: ADDRESS:
For Month of , . Parcel Number Phone Number
OWNER TRAILER
NAME ADDRESS
DATE OF
ARRIVAL (A)
OR DEPARTURE (D)
SPACE SERIAL NUMBER MAKE SIZE YEAR
Pursuant to ARS §42-19154; “Every person who permits a mobile home to be placed upon land which he owns, possesses or controls, in such a manner as will permit occupancy thereof as a dwelling or
sleeping place for one or more persons for a period of thirty days or more, shall keep a register in which shall be entered such information as may be required by the Department”. A copy of the
information disclosed on the register for each thirty day period shall be sent to the County Assessor of the county in which the land is located not later than the tenth day following the month covered by
the report. A person who fails to maintain the register or make the report required by this section is guilty of a misdemeanor.
NOTE; The County Assessor has a report of your entire space inventory on file. Therefore it is necessary
for you to only list new arrivals and departures. Report the current mailing address of each owner.
DOR
82505 (Rev.2/89) OWNER/MANAGER
