PINAL COUNTY ASSESSOR
PO Box 709 ▪ Florence, AZ 85132
Phone: (520) 866-6361
Fax: (520) 866-6353
http://www.pinalcountyaz.gov/Departments/Assessor
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NOTIFICATION OF ARIZONA RESIDENTIAL RENTAL PROPERTY
Pursuant to A.R.S. §33-1901 and 33-1902
INSTRUCTIONS: In compliance with ARS §33-1902(A): an owner of residential property shall maintain with the Assessor in the
county where the property is located information required by this section in a manner to be determined by the Assessor. If the
property is owned by a corporation, limited liability company partnership, limited partnership, trust or real estate investment trust,
include the name, address and telephone number of the business entity and the statutory agent, if applicable.
Pursuant to ARS §33-1902 (B): an out-of-state owner of residential rental property shall designate and record with the County
Assessor a statutory agent who lives in this state and who will accept legal service on behalf of the owner. A person who fails to
comply with any provision of this section shall be assessed a civil penalty of one thousand dollars, plus an additional one hundred
dollars for each month after the date of the original violation until compliance occurs.
Pursuant to ARS§33-1902(I), a fee of $10 must accompany this
registration form for each initial registration and each change of
information in the registry. This fee is non-refundable.
Make checks payable to: Pinal County Assessor
Mail completed registration to:
Pinal County Assessor
PO Box 709
Florence, AZ 85132
F
or Unsecured Mobile Homes Only
List Tax Roll #: _______________________________________
PROPERTY INFORMATION
List County where property is located (required): ________________________________________________________________
Property Type: Single Family Residence Multiple Family Residence Mobile Home MH/RV Park Space
Property Site Address: _____________________________________________________________________________________
City/Town: ________________________________________________________, AZ ZIP: ____________________________
List the year the building was built:______________________________________
OWNERSHIP INFORMATION
Property Owner(s) / Business Entity: ___________________________________________________________________________
Street Address (or P.O. Box): _________________________________________________________________________________
City / State ___________________________________________ Zip: ________________ Telephone #: _____________________
CHECK BELOW TO INDICATE FORM OF OWNERSHIP
Property Owner, list name of owner: _____________________________________________________________________
Corporation, list name of corporate officer: _________________________________________________________________
Limited Liability Company, list name of managing or administrative member: _____________________________________
Partnership, list name of general partner: ___________________________________________________________________
Limited Partnership, list name of general partner: ____________________________________________________________
Trust, list name of trustee: _____________________________________________________________________________
Real Estate Investment Trust, list name of general partner or officer: _____________________________________________
OUT-OF-STATE OWNER’S DESIGNATION OF AGENT
A.R.S. §33-1902(B) requires an out of state owner to designate a statutory agent who resides in Arizona to accept legal service on behalf
of the owner of residential rental property.
Name of statutory agent: _______________________________________Address: ______________________________________
City: ____________________________________, AZ Zip: _________________Telephone#: _________________
REQUIREMENT TO UPDATE INFORMATION:
Under penalty of law the owner(s) of Arizona residential rental property shall update any information listed above within ten days after
a change in the information occur.
I hereby affirm that the information included or attached is true and correct.
_________________________________________________ ______________________________________________________
Print Name Print Name
_________________________________________________ ______________________________________________________
Signature Date
Retain a copy of this completed form for your records
Parcel Number: ___________________________
