HomeMy WebLinkAboutApril 17, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
~;y t~ (~ f~~
F\
L..1
INSTRUCTIONS
APR 1 9 2007
,J'",SS-'" \0;'0. ;<::~, ~: ::ICE
MOBILE HOME PARK OPERATOR (orown8rof land If mobile home subject to f861slocated outside of park): cdMi:)j~tij~~llib~~~Obile
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). NOTE: Exempt furnishings must be subtracted from the fair market value It Included in that figure. Submit form to local Clerk
for computation of parking permit fee.
CLERK: Complete Section C.
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
CLERK
P....,1a (A. 00-83)
Qj
MANUFACTURER'S NAME
Tuyu.u
YR OF MANUFACTURE
IGill
00 YOU HAVE
o Bill OF SALE
NO. OF ROOMS
8ATHS_
SERIAL NUMBeR
5352-
WHER.E PURCHASED
PURCHASE YR PURCHASE PRICE
?-oJ? 30co
UCENSE NO. (IF APPLlOA8LE)
PURCHASED AS
o NEW )2l""useD
WIDTH LENGTH WEIGHT
\~ FT. 10 FT.
COlOR
NO. OF AXLES
o llne
TOTAL ROOMS
DOES MOBILE HOME HAVE
o SKIRllNG
o AIR CONDmONING
o DISHWASHER
SIGNATURl: OF MOBILE HOME OWNER
_SF
--"- SF
_SF
BORMS. _
o FIREPLACE
o WASHER
o DRYER
o PORCH
o PATIO
o CARPORT
OAl:E
1. Total Fair Market Value $
2. Exempt Furnishings _ $
3. NET FAIR MARKET VALUE $
(Subtract line 2 from line 1)
DATE VIEWED OR INSPECTED
SIGNATURE OF ASSESSOR
4. Net Fair Market Value (from line 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 Computation (multiply line 4 by line 5) $
7. Net Tax Rate (after state credits)
(established for preceding January 1 assessment) X
8. Annual Fee (multiply line 6 by line 7) $
9. Gross Monthly Fee (divide Une 8 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 the foUowtng month)
The monthly fee Is due
on or ~efore the 10th
day of each month
thereafter.
;~
WlacoMIn o.partm~ of ~...