No Title - Junked Title Affidavit

Ken Burton Jr.

Tax Collector Serving Manatee County
MANATEE COUNTY TAX COLLECTOR'S OFFICE JUNKED MOBILE HOME AFFIDAVIT

(Double wide 2 affidavits required, triple wide 3 affidavits required)
Title*
Year
Make
VIN Number
The above mobile home was destroyed or removed and has been verified by a physical inspection.*

The mobile home has been destroyed or removedThis is a vacant lotI do not have the Title
Physical Address of Mobile Home

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature of Affiant

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Draw your signature in the box above
Title of Affiant
Your Title
Date

MonthDayYear
For a conformation receipt enter email address here
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Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true
Should be Empty:

Ken Burton Jr.