HomeMy WebLinkAboutMarch 7, 2007
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MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
INSTRUCTIONS
MOBILE HONE PARK OPERATOR (or owner of/and if mobile home subject to fee is/oeafed outside of park): Complete
Section A with mobile home owner. Submit in duplicate to your local Assessorwithin 5 days of the arrival of each mobile home.
ASSESSOR: Complete Section B. Determine the falrmarket value of the mobile home. (Use PA-117. Mobile Home Valuation
Worksheet). NOTE: Exempt furnishings must be subtracted from the faIr market value If included In that figure. Si:elWSO
to local Clerk for computation of parking permit fee.
MAR - 8 2007
CLERK: Complete Section C.
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
CLERK
pAo11a (R. t2~)
AsseSSORS OFFIce
"""~ .
,.. /l/SIN
. ,:;~", :.... :::SEC1l0t.fA', ..::
\ \ 0"1-
MOBilE HOME DESCRIPTION.. ,
MANUFACTURER'S NAMe MODEL OR POPULAR NAME
~~~e...\d
YR OF MANUfACTURE PURCHASE YEAR PURCHASE PRice PURCHASeD AS WHERE PURCHASED
\C\~ ~~ DNEW ~SeD
DO YOU HAVE LICENSE NO. (IF APPUCAflLE) WIDTH LENGTH weIGHT COL.OR
o BILL OF $ALE OTlTI.E \~FT. '1'Q7
NO. OF ROOMS DOES MOBILE HOME HAVE
SATHS_ BDRt.fS_ 0 SKlRTlNG
o AI~ CONDITIONING
o DISHW"SHER
SERiAl NUMBER
c.. \14 OC':J
NO. OF AXlES
TOTAL ROOMS
o FIREI'LAOe
o WI\SHER
o DRYER
o PORO/-l
o PA'l'IO
o CAAJ>OFU
SF
SF
SF
PLEASE .... SIGNA~RIii OF MOilLE HOME OWNER
SIGN HERE ".
DATE VIEWED OR INSPECTED
1. Total Fair Market Value ............ $.
2. Exempt Furnishings ............... - $
3. NET FAIR MARKET VALUE ..... $
(Subtract line 2 from line 1)
SIGNATURe OF AsseSSOR
~
,SeCTION C ... COMPU.TATION OF PARKING PERMIT FEE
4~ Net F~lr Market Value (trom line 3 above) ...................... $
5. % Level of Looal Assessment ....................................... X
(establIshed for preceding Jan. 1 assessment)'
8. Value for Fee Computation (mUltiply line 4 by line 5) .... $
7. Net Tax Rate (after state taxcr8dlt)
(established for preceding January 1 assessment) ......... X
8. Annual Fee (multiply line 6 by line 7) .............................. $
9. Gross Monthly Fee (divide line 8 by 12 months) ............ $
10. lottery Credit (if applicable) ......................................... _ $
11. Net Monthly Fee (:subtract line 10 from line 9) ................ $
The first monthly fee
covers the month of
(linte, month)
and is due on Or
before the 10th day of
(Ent."lhe leI/owing month)
The monthly fee is
due on or before the
1 Oth day of each
month thereafter.
WleC:ClII,1n 0.,,"''''."1 01 Re~enu.