HomeMy WebLinkAboutSeptember 13, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE
INSTRUCTIONS
MOBilE HOME P ARK OPERATOR (or owner of land If mobile home subject to fe8 Is located outside of park): Complete Section A with 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 Hom~lDiiiBnE D
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. SEP 11 2007
CLERK: Complete Section C.
TOBE
COMPLETED
BY
PARK
OPERATOR
AND
MOBilE
HOME
OWNER
ASSESSOR
CLERK
P A-118 (R. 0$-03)
ASS~SSORS OfFICE
OSHKOSri, WiSCONSIN
NAME OF MOBILE HOME OWNER
, No rW\O.- taWlL\/"\
ADDRESS OF MOBILE HOME
'la t? uno
OWNERPERMANENTAOORESS
-=t:i:- 5 g
Qj
MANUFACTU~. R'S NAME
Vt1l\ broo k..
YR OF MANUFACTURE PURCHASE YR
lqlo
00 YOU HAVE
o BILL OF SALE 0 l1TlE
NO. OF ROOMS
BATHS _ BORMS._
SERIAL NUMBER
\Vllof
WHER.E PuRCHASED
2L>V 1
PURCHASE PRICE PURCHASED AS
6liV 0 NEW A US EO
WIDTH LENGTH WEIGHT
I~ FT. 10 FT.
NO. OF AXLES
UCENSE NO. (IF APPLICABlE)
COlOR
TOTAL ROOMS
OOES MOBILE HOME HAVE
o SKIRTING
o AlR CONOmONING
OOISHWASHER
SIGNATURE OF MOalLE HOME OWNER
o FIREPLACE
o WASHER
o ORYER
o PORCH
o PATIO
o CARPORT
_Sf
_SF
SF
DATE VIEWEO 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. % level of local Assessment X
(established for preceding Jan. 1 assessment)
6. Value for Fee Cdmputation (multiply line 4 by line 5) $
7. Net Tax Rate (after state credits)
(established for preceding January 1 assessment) X
8. Annual Fee (multiply Une 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) $
(Enter month)
and is due on or before
the 10th day of
(Enter the foUowlng month)
The monthly fee is due
on or !;lefore the 10th
day of each month
thereafter.
;F!'
'.i.~
WlacoMln Oe\)&ttment of ~ue