HomeMy WebLinkAboutAuthentication CertficationAUTI IENTICATION/CERTIFICATION - MANUFACTURED HOME TAX
(Authentication of Paid Ad Valorem Taxes)
The undersigned certifies under penalty of perjury that the following information is true and correct to
the best of his/her knowledge.
Authentication Number: 2019198 Movement N Title Change [ N Into/Out of Inventory
CURRENT INFORMATION:
Schedule or Parcel Number: M000984 Date: 09/06/2019
Name of Owner(s) of Manufactured Home: BELLIO SILT HOLDINGS LLLP
Situs Address: VIN: 14100375
Title Number: 000386018
SILT, CO 81652 HUD #:
Make: KIRKWOOD 14 X 51
Size: Year Built: 74
SALE INFORMATION:
Name and Mailing Address of Purchaser(s): Sale Price: $0.00
BELLIO SILT HOLDINGS LLLP
PO BOX 21
SILT, CO 81652
Sale Date: 09/06/2019
Assessor's Value: $470.00
MOVEMENT TO:
Situs Address or Legal Description: Mover Name:
Park Name/Name of Land Owner: BELLIO SILT HOLDINGS LLLP
Move Date: Permit Ex iration Date: 10/06/19
Within County: I Mover: _ Agent: f_
d I3 1%
Print Name of Person Signing:
Signature:
Tax Ares' 020
Actual Value: $6,570.00
Current Mill Levy: 65.5430
Assessor or Staff Signature:
Owner:
Y
[1
Telephone Number:/n, ? 6? -67/6r
Garfield ASSESSOR INFORMATION
Assessed Value: $470.00
Prora dWxes duh:
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Number of taxable months:
Garfield TREASURE INFORMATION
Due Paid
Date: 09/06/2019
Date
Tax Year: 2019
Prior Year's Taxes:
Taxes prorated:
Certificate/Permit Fees: 10.00
Total Due:
I certify that all ad valorem taxes due this county applicable to the above described manufactured home have been paid
through the curent tax year including any tax due.
Treasurer or Deputy Signature: _ _ Date:09/06/2019