Morris and McDaniel, Inc. |Assessor Interest Form

Assessor Interest - Registration

If you are interested in serving as an assessor, please complete the following form.

First Name
Middle Initial
Last Name
Address 1
Address 2
City
State
Zip
Work Phone#
Alternate/Mobile Phone#
Work Email
Other Email
Rank
Department
If letter is needed for approval, what is chief's name/email address?
If retired, what month/day/year did you retire? What rank did you retire at and what department did you retire from.
Ethnicity	Caucasian African American American Indian Hispanic Asian Other
Gender	Male Female
Population of Jurisdiction
Have you previously served as an Assessor? Is so, please provide dates, location, ranks assessed, etc.
Comments/Special Needs