HomeMy WebLinkAboutFebruary 28, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
RE'CEIVED
MAR -.2 2007
INSTRUCTIONS ASSESSORS OFFICE
OSHKOSH, WISCONSIN
MOBILE HOME PARK OPERATOR (or owner of land If mob/Ie home subject to feels located outsIde of park): Complete Section A with mobile
home owner. Submit In duplicate to your local Assessor Within 5 days of the arrival of each mobile home.
ASSESSOR: Complete Section 8. Determine the fair market value of the mobile home. (Use PA-117, Mobile Home Valuation
Worksheet). NOT!:: Exempt furnishings must be subtracted from the fair market value If Included In thattlgure. Submit form to local Clerk
for computation of parking permit fee. "~,' ",.11 ,,0 'fl~ ./1 /l "
CLERK: Complete Section C. ~~LY / (/ v L/--.../
TO BE
COMPLETED
-BV
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
CLERK
.....". (R. oe.t3)
MANUFACTURER'S NAME
l\I\a(~ \Ir~l (d
YR OF MANUFACTURE'
\q,
00 YOU HAVE
o BIU OF SAlE 0 nne
NO. OF ROOMS
BATHS ~ BOl'lMS._
ARRIVALpArE
5rl
MOBilE HOME DESCRIPTION
MOOElOR POPUlAR NAME
Qj
PURCHASE YR
l():; '1
PURCHASE PRICE
'1100
SERIAL NUMBER
4tf,o
WHERE PlIRCHASED
~nVe:~
COLOR
NO. OF AXLES
UCENSE NO. (IF APPUCABl.E)
rOTALROOMS
OOES MOBILE HOME HAVE
o SKIRllNG
o All=l CONomONlNG
o DtSHWASHER
SIGNATURE OF M08ILEHOME OWNER
~SF
_________SF
_SF
o FIRePLACE
o WASHER
o ORYER
o poRCH
o PAnO
o CARPORT
1. Total Fair Market Value $
2. Exempt Furnishings _ $
3. NET FAIR MARKET VALUE $
(Subtract line 2 from ,line 1)
SIGNATURE OF AssessOR
4. Net Fair Market Value (from nne 3 above)
$
The first monthly fee
covers the month of
5. % Level of Local Assessment X
, (established for preceding Jan. 1 assessment)
, 6. Value for Fee Cdmpu~tlon (multiply line 4 by line 5) $
7. Net, Tax Rate. {after state crad"s):
(establi$h~d for preceding January 1 assessment)
a.;Anri"~'Fee{muttIPlYlIfle 6 bYlln~ 7) $ ..
'9.ci'roSs Monthly Fee (divide /lneS by 12 months) $
10. Lottery Credit (if applicable) , _ $
,
11. Net Monthly Fee (subtract line 10 from line 9) $
, (Enter month)
and Is due on or before
the 10th day of.
(Enter theofoUowlng month)
The mOnthly fee Is due
on or I?efore the 10th
day of each month
thereafter.
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WlIcoMIn ~~ of Rnotnue