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Unit Information: 2. 3. 4. 5. 6. Employee/Owner Occupied # of units unable to be occupied and why: Occupancy Rate: Expense Ratio: Please check which utilities & services are included in rent: Heat( ) Gas ( ) Electricity ( ) A/C ( ) Washer/Dryer ( ) Parking ( ) 1. __Singlewide Security ( ) Swimming Pool ( ) Clubhouse ( ) Parking Information: Lot Parking # of Spaces: Carport # of Spaces: Cost: $ Garage # of Spaces: Cost: $ All information including the accompanying schedules and statements have been examined by me and to the best of my knowledge and belief are true, correct, and complete. Contact Person: Management Firm (if applicable) Address: Phone: Date: Allen County Mobile Survey Allen Assessor Rousseau Fort Ph [PHONE REDACTED] Fax [PHONE REDACTED] 46802 IN Wayne 415 Suite Street Main E 1 Centre, O'Day Stacey - County # Units Rent Range $ $ $ $ $ $ $ $ $ $ $ $ Signature: Park Home Title: Per IC 6-1.1-35-9, any information pertaining to income expense is constitutionally protected and will remain confidential. Water ) ( only) (lot Owner: Mailing Address: Contact Number: E-Mail Address: Name of Preparer: Community Name: Property Address: Parcel Number *As part of data submission, please include the last three years (2023-25) of income & expense records Ave 2025 Rent # utilities includes rent where units of Doublewide only) (lot Triplewide only) (lot Singlewide home) mobile (with Doublewide home) mobile (with Triplewide home) mobile (with