HomeMy WebLinkAboutAugust 20, 2007
MOBILE HOME STATEMENT
INSTRUCTIONS
RECEIVED
AUG Z 2 2007
MOBILE HOME PARK OPERA TOR (or owner of land if mobile home subject to fee is located ~lJtside 0/ parkJj~~,?~~~~C;~~ith mobile'
home owner. Submft in duplicatato 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
Worxsheet). NOTE: E:.<:empt furnishings must be subtracted from the lajr marxet value if included in that figure. Submit lorm to local Clerk
for computation of parking permit fea.
CLERK: Complete Section C.
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
TAXATION DISTRICT
City of Oshkosh
NAME OF PARK
Edison Estates
eoJJN'f'(
Winnebago
ARRIVAL OA rE
q/l
ctz
31 '-16 GrltiVl..>h) rt.
AOORESS OF l.lGBIL~ HOl.lE
-#' 103'
MOBILE HOME DESCRIPTION
!.lODEL OR POPULAR NAJ.lE
SERIAL NUMBER
IllS5i.../S8'
lJANUFACTURER'S NAME
\Zed fl\.Q! n
YR OF !.lANUFACruRE YR. OF PURCHASE PURCHASE PRice
1<1 Cj 82007 l.4" cu0
00 YOU HAVE LX:ENSE NO. (IF APPl.lCASLE) WIDT'H I.ENGT'H
o SILL OF SALE I"" FT. 8b FT.
COLOR
NO. OF AXLES
NO. OF ROOl.lS OOES l.lOBILE HOl.lE HAVE
BA T'HS _ BOAl.lS. _ 0 SKIRTING
o AIR CONDITIONING
TOTAL ROOMS 0 DISHWASHER
SIGNA TURE OF MOBILE HOLlE OWNER
o FIAE?l.).CE
o WASH,,;:l
o DRYER
o POACH ~ SF
o PATIO _SF
o CARPORT SF
DArE
1. Total Fair Market Value $
2. Exempt Furnishings - $
3. NETFAJR MARKET VALUE $
(Subtract line 2 from line 1)
SIGNATURE OF ASSESSOR
'~li~@11mIE!!f.mi~~J~&ilt~!j!~1IEB!lii:~~;';:'f:~<<k;;~;:::::.:.:.:.:.:..:.::...:.:...:::.....:.:.:~<~;,fi;:i:!\!!.!
4. Net Fair Market Value (from line 3 above) $ The first monthly fee
covers the month at
5. % Level of Local Assessment X
(established tor preceding Jan. 1 assessment) (Entef month)
6. Value for Fee Computatjo~ (multiply line 4 by lina 5) S
CLERK .' 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) $ (Entef the lollowing 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 10th
day of each month
11. Net Monthly Fee (subtract line 10 from line 9) $ thereafter.
Wl&<:onaln Oi>GaI1ment 01 RVi tnU'