DX-1302 Listing Page 2

Ask the contact person of the mobile home park – Do you have any maps of the mobile home park that I can take with me?

Section 6 – MOBILE HOME PARK PAGE
Mobile home park address

(7) What is the total number of mobile homes, trailers, AND empty trailer lots/sites in the park?

(1) Block No.
(3a) Road/street name

(2) House No.

(8) Mobile home park number

(9) Name of park
(10) Name/Title/Phone No. of
contact person for park
(4a) Rural Rte. No.

(4b) Box No.

(5) PO Box No.

(6) ZIP Code

(11) Information obtained from
Line
No.

Map Spot No.

House/Lot No./Physical description
(b)

(a)
Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

Number

Letter

1

HH member

2

Proxy

3

Manager

4

Road/street name

Rural
Rte. No.

Box No.

PO Box No.

Unit status

ZIP Code

(c)

(d)

(e)

(f)

(g)

(h)

Observation
Obtain householder name for areas with non-city style addresses
(i)
First

MI

Last

1
2
3
4
5
6
7

0005

8
9
10
11
12
13
14

Page 81

15
UNIT STATUS:

1 – Occupied or vacant and intended for occupancy

4 – Unfit for habitation

5 – Boarded up

6 – Storage of household goods

7 – Empty trailer lot/site

8 – Other

FORM DX-1302 (3-27-2007)

FORM DX-1302, Page 81 Base copy – Prints black ink (30%, 50%, and 100%)

FORM DX-1302, Page 81 Overlay – Prints Yellow PMS 123 (20%)