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2. First Name*
3. Last Name*
5. Property Address*
7. City*
8. State
9. Zip Code
11. Phone Number
12. Email Address
14. Parcel Number(s) (if known)

    ##-###-####

16. USE OF PROPERTY - Answer "Yes" or "No" for the following:
18. Residential*

    1. Yes
    2. No
19. Agricultural*

    1. Yes
    2. No
20. Seasonally Used*

    1. Yes
    2. No
21. Owner Occupied*

    1. Yes
    2. No
23. Relative Occupied*

    1. Yes
    2. No
24. Rented*

    1. Yes
    2. No
26. Select all that apply to your home:
28. Flooring*

    1. Carpet
    2. Hardwood
    3. Vinyl
    4. Tile
    5. Laminate
    6. Finished Concrete
    7. Other
29. Walls*

    1. Sheetrock
    2. Plaster
    3. Log
    4. Paneling
    5. Other
30. Heating*

    1. Forced Air
    2. Hot Water
    3. Wood
    4. Geothermal
    5. In-Floor
    6. Space Heater
    7. Other
31. Air Condition:*

    1. Central Air
    2. Wall Mount
    3. Window Unit
    4. None
    5. Other
33. Foundation:*

    1. Concrete Block
    2. Poured Concrete
    3. Wood
    4. Rubble/Stone
    5. Concrete Slab
    6. Piers
    7. Other
35. Number of Bathrooms

    Half Bath = sink & toilet; 3/4 Bathroom = sink, toilet & tub OR shower; Full Bathroom = sink, toilet, bathtub AND shower

37. Half Bathrooms
    -- Select One --01234More than 4
38. 3/4 Bathrooms
    -- Select One --01234more than 4
39. Full Bathrooms
    -- Select One --01234more than 4
41. Number of Bedrooms
43. Basement
    -- Select One --012345more than 5
44. Main Floor
    -- Select One --012345more than 5
45. 2nd Story
    -- Select One --012345more than 5
47. Basement Finish: (# of square feet or % of Foundation
48. Year of Last Remodel/Update to House/Cabin:
50. What was updated in the Remodel:
52. Other Buildings or Outbuildings (additional houses, garages, pole sheds, barns, granary, grain bins, etc.):
    Please indicate type of structure and size of the building (garage 24 x 24, barn 36 x 72, grain bin 7500 bushels)
54. Comments about your property:
56. Thank you for filling out our questionnaire. We appreciate your cooperation and look forward to seeing you again in five years. If you have questions, please call the assessor for your area.
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58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

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