BUTLER COUNTY APPRAISER’S OFFICE
TRUCK/TRAILER APPRAISAL FORM
Tax ID#___________
(County Use)
Please complete the information below pertaining to the vehicle on the attached registration and return to the above address as soon as
possible for an accurate appraisal. If you have any questions please call.
Owner Name: ______________________________________ Business Name: ____________________________________________
Mailing Address: _____________________________________________________________________________________________
Property Location Address: _____________________________________________________________________________________
TRUCK INFORMATION: Year: _________ Make: _________________ Model: _________________ Series: _____________
Vin#: _________________________________________
Reg. Cab: ______
Brakes:
Ext Cab: _______
Gas: ______ Diesel: ______
Crew Cab: _______
Hydraulic _____, Air _____
Super Cab: _______
Drive: 4x2 _____, 4x4 _____, 6x4 _____
Sleeper: No _____, Yes _____, Size ______
Power Seats: Yes ______, No ______
Quad Cab: ______
Sun Roof: Yes _____, No _____
Engine Size/Type: ________________
Off Road Pkg:
Mega Cab: ________
Yes ______, No ______
Navigation System: Yes ______, No ______
Leather Seats: Yes ______, NO ______
Power Windows: Yes ______, No ______
Aluminum/Alloy Wheels: Yes ____, No ____ Rear Entertainment System: Yes ____, No ____ Theft System: Yes ____ No_____
Weight Classification: _____________
Purchase Date: _____________________
BED / BODY INFORMATION:
Year (if different then the truck) _____________ Size/Length __________________
Type: ___Flatbed
___ Refrig
___ Dump Bed
___ Cement Mixer
___ Dry Frght
___ Step Van
___ Grain Bed
___ Refuse
Purchase Date: __________________________
TRAILER INFORMATION:
Purchase Price: $__________________
___ Pickup Bed
___Utility
___ Other (describe)_______________________
Purchase Price $ ___________________________
Year: __________ Make: _____________________
Model: _______________________
Series: ________________ VIN #: ____________________________ Size: _________________ # Of Axles: ______________
Type: ____Flatbed
____Refrig
___Lowboy
___Car Hauler
___Dry Frght
___ Cattle/Stock
___Step Van
____Horse (# Of Horses________)
___Refuse
_____Camper
____ Tank
____Other (describe) ______________________
_____Travel Trl
Purchase Date: __________________________
TRUCK/TRAILER USED FOR:
____Gooseneck
____Self – Contained
Purchase Price: $ ___________________________
_______Farm Use
______Commercial Use
_______ Personal Use
____Check here if this vehicle was moved to this county from another county or state. Date moved here ___________________
Is this vehicle a replacement vehicle? ____ Yes ____ No If yes, list the vehicle it replaced ______________________________
Is this vehicle leased? ____Yes ____No if yes, name of leasing company _____________________________________________
Commercial Owners Only: Please indicates whether or not your trucks or trailers are State Assessed by the Kansas Property
Valuation Division. ____Yes ____No, these vehicles are/are not state assessed. The appraiser may request a copy of your
Kansas Motor Carriers Schedule for verification of state assessment.
______________________________________________
Signature of Owner or Authorized Agent
205 WEST CENTRAL
EL DORADO, KS 67042
______________________
Date
Please visit our web site at www.bucoks.com
____________________________
Phone#
316-322-4220 / 800-822-6346
Fax # 316-322-4320