Form of collateral list and supplement

The form of the collateral list and a supplement for mobile or manufactured homes must be substantially as follows:
Collateral List For ____ County
Lienholder: ____
Address for Notice: ____
Date: ____
Name(s) of Owner(s): Address of Home: ____
Other Address of Owner(s): ____
Zip Code: ____
Year of Home: ____
Make/Model: ____
Size of Home: ____
Full Serial Number: ____.