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2. Please call the Treasurers Office at 208-446-1005 if you have questions about this form.

4. AIN#*

6. KOOTENAI COUNTY

   MOBILE HOME/PERSONAL PROPERTY PREPAY FORM

8. PIN #*
9. DATE*
   DATE
11. SELLER NAME*
13. SELLER ADDRESS*
15. VIN #*
16. SIZE

    ex. 99 X 99

17. YEAR BLT.
19. Title Company
20. Title Company Phone #
21. Escrow #
23. Title Company Email Address*
24. Closing Date
    Closing Date

25. *Prepay quotes are only good for (5) five business days.

27. REASON FOR PREPAYMENT*

    1. TITLE TRANSFER
    2. CHANGE OF OWNERSHIP
    3. CHANGE OF LOCATION
    4. STATEMENT OF INTENT NREV
    5. REVERSAL OF NREV
    6. OTHER

29.        TO BE FILLED OUT IF MOBILE IS BEING SOLD 
    -MOBILE HOME BEING SOLD TO:

31. BUYER NAME:*
32. BUYER ADDRESS:*
34. CITY, STATE, ZIP:*
35. BUYER PHONE #:*

37.        TO BE FILLED OUT IF MOBILE IS TO BE MOVED
    -IN COUNTY

39. PROPERTY OWNED BY:
40. PARCEL #:
42. LOCATION:

44.        TO BE FILLED OUT IF MOBILE IS TO BE MOVED
    -OUT OF COUNTY

46. LOCATION:
47. COUNTY:
49. STATE:
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field