Form Dte 41 - County Manufactured And Mobile Home Registration Certificate Form

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DTE Form 41
Registration No. __________________
Revised 6/00
RC 4503.061
County Manufactured and Mobile Home Registration Certificate
Owner Information
Name ______________________________________________________________________________
Mailing Address ______________________________________________________________________
______________________________________________________________________
Telephone Number ____________________________________________________________________
Home Information
Address of Home _____________________________________________________________________
Home Located in ____________________Township/Municipality__________________ School District
Name of Court or Park Where Located (if any)______________________________________________
Make ________________________ Model ________________________ Year Manufactured ________
Serial No. _______________________________ Certificate of Title No. _________________________
Date Acquired ____________ Date Entered Ohio ____________Outside Dimensions _______________
County of Previous Registration in Ohio (if any)______________ Registration No._________________
Name of Previous Owner (if any)_________________________________________________________
Sale Price
1. Total Sale Price of Home
$_________________
2. Portion, if any, of Total Sale Price Paid for Items Other Than the Home
*
(furnishings, equipment, and other property not attached to home)
$_________________
3. Net Sale Price of Home (line 1 minus line 2)
$_________________
*
If home was purchased from a dealer attach copy of invoice or purchase order, itemizing the costs for
the home, furnishings, equipment, and other property.
Application for 2½% Reduction: Will this home be your principal residence by January 1 of next year.
_____ Yes
_____ No
I DECLARE UNDER PENALTIES OF PERJURY THAT THIS STATEMENT HAS BEEN EXAMINED BY ME AND
.
TO THE BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT, AND COMPLETE STATEMENT
______________________________________________
____________________
SIGNATURE OF OWNER
DATE
____________________________________________________________________________________
INSTRUCTIONS
1. This form must be filed within 30 days after a manufactured or mobile home first acquires situs in a
county, or within 30 days after ownership transfers if the home stays in the same county. Failure to
comply will result in a $100 penalty being imposed, which will constitute a lien on the home.
2. File this form with the county auditor where the home is located.
3. This form should be filed only when an owner first registers the home in a county.

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