HomeMy WebLinkAboutAugust 28, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
INSTRUCTIONS
MOBILE HOME PARK OPERATOR (or owner of land if mobile home subject to fee is located outside of park): Complete
Section A with mobile home owner. Submit in duplicate to your local Assessor within 5 days ofthe arrival of each mobile home.
ASSESSOR: Complete Section B. Determine the fair market value of the mobile home. (Use P A-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. RE eEl V r-:: ;-
CLERK: Complete Section C.
AUG 2 9 2007
TO BE ;:1]: J I {
COMPLETED PARK ADDRESS
BY
SECTION A
TAXATION DISTRICT SCHOOL DISTRICT
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\-,
I
PARK MOBILE HOME DESCRIPTION
OPERATOR MANUFACTURER'S NAME MODEL OR POPULAR NAME
AND
MOBILE
HOME
OWNER
ASSESSOR
CLERK
PA-118 (R. 12-04)
SERIAL NUMBER
YR OF MANUFACTURE PURCHASE YEAR PURCHASE PRICE
DO YOU HAVE
o BILL OF SALE OTITLE
NO. OF ROOMS
BATHS BDRMS
PURCHASED AS WHERE PURCHASED
o NEW 0 USED
LICENSE NO. (IF APPLICABLE) WIDTH LENGTH WEIGHT COLOR
NO. OF AXLES
FT. FT.
DOES MOBILE HOME HAVE
o SKIRTING
o AIR CONDITIONING
o DISHWASHER
o FIREPLACE
o WASHER
o DRYER
\
o PORCH
o PATIO
o CARPORT
SF
SF
SF
TOTAL ROOMS
PLEASE ..
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
~
SECTIONC -'- COMPUTATION OFPARKINGPER.N\ITFEE
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 tax credit)
(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 g) ................ $
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.
Wisconsin Department of Revenue