HomeMy WebLinkAboutJune 28, 2007
MOBilE HOME 5T A TEMENT OF MONTHLY P ARK;NG PERMIT FEE A', ,<.r~
INSTRUCTIONS / Y'\:!
MOBILE H ME PARK OPERA TOR (or owner of land if mobile home subject to fee is located outside of park): Complete Section A with mobile
home owne . Submit in duplicate to your local Assessor within 5 days of the arrival of each mobile home.
ASSESSO : Complete Section ~. ~etermine the fair market value of t~e mobile home: ~Use P A- ~ 17, M~b~~tttp~~~~!Y1tjon
Worksheet). NOTE: Exempt furmshlngs must be subtracted from the faIr market value if Included In that fIgure. "Suomlt fo1m to local Clerk
for computa ion of parking permit fee.
CLERK: Co plete Section C.
?,
l
TOB
CO~Pl TED
I BY
PAR
OPERA OR
ASSES OR
TAXATION DISTRICT
City of Oshkosh
t\SSE~ Ff{':E
tJ5i-if'\C;J(j, VVI~i,CONSf,t1i
tlllf~Ellimll!;:~::::: . ..::::':::.:...:.:.:::.]IIIII!~llj1jllll1!~111111!1!111:::llji!llljllii[I:11i]I':I.~~i:[il'ljl~j!l!rljlll:!:jj!l!;!:i~;:i;::.::t;!~(:~::. :~ ;
NAME OF MOBilE HOME OWNER
Richard C. Kossel
NAME OF PARK ADDRESS OF PARK
Patrician Village 1951 Virginian
COUNTY ARRIVAL DATE ADDRESS OF MOBILE HOME
Winnebago 07/01/07 1415 Indigo Drive
MOBILE HOME DESCRIPTION
MODel OR POPULAR NAME
-'1
MANUFACTURER'S NAME
Peerless
SERIAL NUMBER
06-L-21969
VR OF MANUFACTURE
1989
WI
NO. OF AXLES
o FIREPLACE
~WASHER
RVER ::.
o PORCH
o PATIO
o CARPORT
DATE
_SF
_SF
SF
DATE VIEWED OR INSPECTED
1. Total Fair Market Value
$
-$
$
SIGNATURE OF ASSESSOR
2. Exempt Furnishings
3. NET FAIR MARKET VALUE
(Subtract line 2 from line 1)
:~:::~~t.:~:::::::::;;:~;:~~~~~"$::~::~::::::~~-:::f~:~~~:*~~-::$::::::~~~:*~3;::~;~:~::~::~.::::~3:::~~:;$~~~:*~~:::~~~~~:~::;:;~:~::::::~~f.:$:::-;-~~::.\~~~::::~::~~.:~:*;:::~~.;:~:;~!-;?-~:::
~;'eSII2t11g~f.\tS~M~ElliiltSlilSiiinilf!~gifl~M!w{tif;:~
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) (Enter month)
6. Value for Fee Computation (multiply line 4 by line 5) $
CLER and is due on or before
7. Net Tax Rate (after state credits) the 10th day of
(established for preceding January 1 assessment) X
8. Annual Fee (multiply line 6 by line 7) $ (Enter the following month)
9. Gross Monthly Fee (divide line 8 by 12 months) $ The monthly fee is due
10. Lottery Credit (if applicable) -$ on or before the 10lh
day of each month
11. Net Monthly Fee (subtract line 10 from line 9) $ thereafter.
D~."~ Iq. 09.921
Wl.,;onsln Depanmem of RO\'&nue