HomeMy WebLinkAboutAugust 29, 2007
MOBilE HOME STATEMENT OF MONTHLY PARKIN PERMIT FEE
INSTRucn NS
MOBILE HOME PARK OPERA TOR (or owner of land if mobile home subjec to fee is located outside of park): Complete Sectidn A with mobile
home owner, Submit in duplicate to your local Assessor within 5 days of he arrival of each mobile home. 1i i
1 !
ASSESSOR: Complete Section B. Determine the fair market value of the mobile home. (Use PA-117, Mobile Home V iuation
Worksheet). NOTE: Exempt furnishings must be subtracted from the fair market value if included in that figur&t~'i 'ltdtrft"\to local Clerk
for computation of parking permit fae.
CLERK: Complete Section C.
AUG 2 9 2001
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
City of Oshkosh
NAME OF PARK
Patrician Village
COUtHY ARRIVAl.. DATE
David and Donna Dobson
ADDRESS OF PARK
Vir inian Street
ADDRESS OF MOBILE HOME
Winnebago
9/1/07 1611 Indi 0 Drive
MOBILE HOME DESCRIP1l0N
MODEl. OR POPUl.AR NAME
Rollohome
PURCHASE PRICE
2007 $25 000.00
lICENSE NO. (IF APPUCASlE) WIDTH
----------- 16 FT. 80 FT.
Inc.
NO. OF AXlES
MANUFACTURER'S NAME
Wick
YR OF MANUFAC1lJRE
1994
00 YOU HAVE
o Bill OF SAlE
NO. OF ROOMS
SA THS .2-.::
"\
o AREPu.cE
~ WASHER
~ DRYER ~
o PORCH
o PATIO
o CARPORT
DATE
_SF
_SF
SF
DORMS. -3-
TOTAL ROOMS
7
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 '
4. Net Fair Market Value (from line 3 above) $ The first monthly fee
covers the month of
5. 0/0 Level of local Assessment X
(estabfished for preceding Jan. 1 assessment) (Enter month)
6. Value for Fee ~omputation (multiply line 4 by fine 5) $ and is due on or before
CLERK
7. Net Tax Rate (atter 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 mOnlh)
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.
o~ ..? Iq 09.9'2l
Wisconsin Department cA Revenue