HomeMy WebLinkAboutAugust 14, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
R.ECEIVED
AUS 2 0 2007
INSTRUCTIONS
,~$:SESSORS .oFFice
MOBILE HOME PARK OPERA TOR (or owner of land if mobile home subject to fee is located outside of park): c~~~~~cYrc;~t~r~mobile
home owner. Submit in duplicate to your local Assessor within 5 days of the arrival of each mobile home.
ASSESSOR: Complete Section B. 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 if 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
D~"O IQ 09.92\
TAXATION DISTRICT
NAME OF MOBilE HOME OWNER
Cit of Oshkosh
NAME OF PARK
Patrician Villa
COUNTY
Winneba 0
Vir inian Street
ADDRESS OF MOBILE HOME
8 1 0 1318 Indi 0 Drive
MOBILE HOME DESCRIPnON
MODEL OR POPULAR NAME SERIAL NUMBER
~l
~
"~i
~
MANUFACTURER'S NAME
1995
00 YOU HAVE
o BilL OF SALE
NO. OF ROOMS
lJ 7'
BATHS ~ BDRU8. ~
16
TOTAL ROOMS
DOES MOBILE HOME HAVE
~ SKIRTING
I!1iI. AlR CONDITIONING
\J!El DISHWASHER
S~TURE OF MO~I~ H9~' OWN~R
)1'tLjf "" j '\ ,~7!.,i!.iL......., I
'.<' .'- ,'''-C_,... r ..."-(,,.... , i
I
o FIREPLACE
J&1 WASHER
l$4 DRYER .::,
.
~ PORCH _SF
o PATIO _SF
o CARFORT SF
OJ
1. Total Fair Market Value $
2. Exempt Furnishings - $
3. NET FAIR MARKET V AWE $
(Subtract line 2 from line 1)
SIGNATURE OF ASSESSOR .
~llir~IIIII~llllr"""'" .
4. Net Fair Market Value (from line 3 above) $
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 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
(Enter month)
and is due on or before
the 10th day of
(Enter the following month)
The monthly fee is due
on or before the 10th
day of each month
thereafter.
WllCOnaln Department 04 RW9IlUlt