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STATE OF ARIZONA MANUFACTURED HOUSING, MOBILE HOME AND (Navajo County)

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STATE OF ARIZONA
MANUFACTURED HOUSING, MOBILE HOME AND MOBILE OFFICE
ACQUISITION AND SALES REPORT REPORT FOR MONTH AND YEAR ________ / ________
(SEE INSTRUCTIONS PAGE)
PAGE _______ OF _______
CHECK HERE TO REPORT ZERO SALES
PREVIOUS OWNER
AND LOCATION
CO.
NO.
NEW OWNER
AND LOCATION
NEW OWNER MAILING
ADDRESS FOR TAX BILL
CO.
NO.
RE-
LOC
(Y/N)
RES.
OR
OFF.
SGL.
OR
MULTI
MANUFACTURER
MODEL NAME
MODEL YEAR
SIZE
HUD ID #
MFG SERIAL #
MANUFAC.
LIST PRICE
(ON TITLE)
RETAIL
SELLING
PRICE
SALE TO
DEALER
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
X
(11)
HUD #
SER #
(12) (13) (14)
X
HUD #
SER #
X
HUD #
SER #
X
HUD#
SER#
X
HUD #
SER #
X
HUD #
SER#
Pursuant to A.R.S. § 41-4040
, Reports by dealers to the Departrment of Revenue and County Assessor. Every dealer who acquires or sells a previously titled manufactured home or
mobile home, [or park model] as defined in A.R.S. 42-19151, shall submit a written report of all such acquisitions and sales to the Department of
Revenue, [Property Tax Unit] and to the
county assessor of the county where such dealer is located. Such report shall be
submitted by the fifteenth day of each month for the period of the previous calendar month.
______________________________________________
Prepared By (Print)
Electronic copies of this form are available at: https://www.azdor.gov/Portals/0/Property/82525.pdf.
Completed forms must be sent by the 15th of the following month to the Arizona Department of Revenue (ADOR) with a copy to your local county assessor. Completed forms may be
emailed to both ADOR and the county assessor by clicking the submit button under the appropriate county assessor information on the back of this form.
______________________________________________
Preparer’s Phone Number
Completed forms may also be sent by U.S. Mail to: Arizona Department of Revenue, Local Jurisdictions District/Property Tax Unit, 1600 W. Monroe, Phoenix AZ 85007.
Fax numbers and mailing address information for each county assessor’s office are included on the back of this form.
DOR 82525 (Rev. 07/2017)
________________________________________________________
Dealer License Number
__________________________________________________
Mailing address
________________________________________________________
Licensed Dealer Number
Print
Clear Form
CO. NO. COUNTY
1. APACHE COUNTY ASSESSOR
P.O. BOX 770
ST. JOHNS, AZ 85936
(928) 337-7624 FAX: (928) 337-3386
2. COCHISE COUNTY ASSESSOR
P.O. BOX 168
BISBEE, AZ 85603
(520) 432-8650 FAX: (520) 432-8698
3.
COCONINO COUNTY ASSESSOR
110 EAST CHERRY AVENUE
FLAGSTAFF, AZ 86001
(928) 679-7962 FAX: (928) 213-9242
4. GILA COUNTY ASSESSOR
1400 EAST ASH STREET
GLOBE, AZ 85501
(928) 425-3231 FAX: (928) 425-0408
5. GRAHAM COUNTY ASSESSOR
921 THATCHER BLVD.
SAFFORD, AZ 85546
(928) 428-2828 FAX: (928) 428-5951
6. GREENLEE COUNTY ASSESSOR
P.O. BOX 777
CLIFTON, AZ 85533
(928) 865-5302 FAX: (928) 865-4417
7.
MARICOPA COUNTY ASSESSOR
301 WEST JEFFERSON, MH Division
PHOENIX, AZ 85003
(602) 506-3291 FAX: (602) 506-7335
8.
MOHAVE COUNTY ASSESSOR
P.O. BOX 7000
KINGMAN, AZ 86402
(928) 753-0703 FAX: (928) 753-0749
GENERAL INSTRUCTIONS:
ALL INFORMATION MUST BE TYPED or PRINTED
THIS IS A FILLABLE FORM AND MAY ALSO BE COMPLETED ONLINE
• Report must be led even if there were no transactions.
• To report with no activity enter dealer license number and check the zero sales box.
•
Dealer License Number as issued by Office of Manufactured Housing.
• Complete Dealer Name as it appears on Dealer License.
• Complete Address.
• Month and Year of sales being reported.
• Fill in all spaces, if information is not available indicate “UNK”.
THIS REPORT IS USED BY:
COUNTY ASSESSORS in preparing annual tax rolls by identifying a change of ownership and/or location.
DEPARTMENT OF REVENUE in completing annual sales ratio studies used in establishing values for property
taxation.
NOTE: Your report is not used by or furnished to the Income or TPT (Sales Tax) Sections of the Department
of Revenue.
ACQUISITION AND SALES REPORT INSTRUCTIONS
1.
PREVIOUS OWNER and LOCATION: Enter previous Owner (as per Title) and physical address where unit
was located.
2. CO NO.: Enter previous county number (reference chart on this page).
3. NEW OWNER and LOCATION: Enter New Owner and the physical location where the unit may be
inspected. If the home has been signed over to a dealer, report the dealer’s name and dealer’s sales lot.
4. NEW OWNER MAILING ADDRESS FOR TAX BILL: Enter mailing address if different than location.
5. CO NO.: Enter new county number (reference the chart on this page).
6. RE-LOC. (Y / N): Enter “Y” (YES) if the home will move, “N” (NO) if it will remain at its current site.
7. RES. or OFF.: Enter “R” if the unit is to be used as residence. Enter “O” if used as an ofce.
8. SGL. or MULTI.: Enter “S” for single section, enter “D” for 2 sections, “T” for 3 sections.
9. MANUFACTURER: Enter the manufacturer of the unit.
MODEL NAME: Enter the model name or number, if known.
10. MODEL YR: Enter the year manufactured as shown on the title.
SIZE: Enter the overall exterior measurement as Width X Length.
11. HUD NUMBER: Enter HUD number, if shown.
COMPLETE SERIAL NUMBER: Enter the COMPLETE serial or VIN Number as shown on title. For
multi-section units 1234A/B is acceptable.
12. MANUFACTURER’S LIST PRICE (ON TITLE): Enter the original Factory List Price (FLP) from title.
13. RETAIL SALES PRICE: Enter the actual sales price. 0 is acceptable ONLY for dealer transactions.
14. SALE TO DEALER: Check this box if the sale was made to a dealer.
COUNTY NUMBER AND COUNTY NAME
(Click the submit button to email completed form to your County Assessor and the Department of Revenue)
CO. NO. COUNTY
9. NAVAJO COUNTY ASSESSOR
P.O. BOX 668
HOLBROOK, AZ 86025
(928) 524-4086 FAX: (928) 524-4291
10. PIMA COUNTY ASSESSOR
115 NORTH CHURCH AVENUE
TUCSON, AZ 85701
(520) 740-8630 FAX: (520) 792-9825
11.
PINAL COUNTY ASSESSOR
P.O. BOX 709
FLORENCE, AZ 85232
(520) 866-6361 FAX: (520) 866-6353
12.
SANTA CRUZ COUNTY ASSESSOR
P.O. BOX 1150
NOGALES, AZ 85621
(520) 375-8030 FAX: (520) 761-7814
13.
YAVAPAI COUNTY ASSESSOR
1015 FAIR STREET
PRESCOTT, AZ 86305
(928) 771-3220 FAX: (928) 771-3181
14.
YUMA COUNTY ASSESSOR
410 SOUTH MAIDEN LN.
YUMA, AZ 85364
(928) 373-6040 FAX: (928) 373-6041
15.
LA PAZ COUNTY ASSESSOR
1112 JOSHUA AVE., STE. #204
PARKER, AZ 85344
(928) 669-6165 FAX: (928) 669-9740
TO SEND A COURTESY COPY TO
OFFICE OF MANUFACTURED
HOUSING, CLICK HERE.
Email Form to Apache County
Email Form to Navajo County
Email Form to Cochise County
Email Form to Pima County
Email Form to Coconino County
Email Form to Pinal County
Email Form to Gila County
Email Form to Santa Cruz County
Email Form to Graham County
Email Form to Yavapai County
Email Form to Greenlee County
Email Form to Yuma County
Email Form to Maricopa County
Email Form to La Paz County
Email Form to Office of Manufactured Housing
Email Form to Mohave County
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STATE OF ARIZONA MANUFACTURED HOUSING, MOBILE HOME AND (Navajo County)

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Completed 18 July 2020

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