Form 50-292 Request For Statement Of Unpaid Taxes On Manufactured Home

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Comptroller
50-292
T
E
of Public
S
X
Accounts
(12-01/2)
A
FORM
REQUEST FOR STATEMENT OF UNPAID TAXES ON MANUFACTURED HOME
County appraisal district / County tax office name:
Phone (area code and number):
Fax (area code and number):
Mailing address:
Taxing units where manufactured home is located (if known):
City, state, ZIP Code:
Date of request:
________ / ________ / ________
Owner’s name:
Property account number (optional):
Step 1:
Owner’s name
Current mailing address (number and street):
and address
City, state, ZIP code + 4:
Phone (area code and number):
Property description:
Step 2:
Describe the
Make: _________________________________ Model: _____________________________ Year Built: ______
property
Serial Number or HUD Label Number: ____________________________________________________________
Step 3:
Physical address: ____________________________________________________________
Location of
manufactured
___________________________________________________________________________
home
___________________________________________________________________________
Step 4:
Signature
________________________________________________________ Date: _______________
of person
print
requesting
________________________________________________________
here
statement
Current mailing address (number and street)
Fax (area code and number):
Step 5:
Address to
send tax
City, state, ZIP code + 4:
Phone (area code and number):
statement
Step 6:
To cover the costs for this request, a fee of $ _________ must be paid for each statement requested.
Fee
payment
Fee Paid: $ ____________

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