HomeMy WebLinkAboutOctober 24, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE ~
~ .~~ ~C;,~~S ~~SE
....YJ..y"s-. "'C~S"" \oVISCON~INi
MOBILE HOME PARK OPERATOR (or owner of land If mobile home subject to feels located outside of park): Complete Section A with mobile
home owner. Submit In dupllcate to your local Assessor within 5 days of the arrival of each mobile home, .
INSTRUCTIONS
ASSESSOR: Complete Section 8. 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. Svbmit 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
PAone (R. w-93)
Qj
MANUFACTURER'S NAME
C,'oer- 0\-
YR 01' MANUFACTURE
V1 '3 ~
00 YOU HAVE
o BIlt. OF SALE 0 TITlE
NO. OF ROOMS
MOBILE HOME DESCRIPTION
MODEL OR POPUlAR NAME
SERiAl NUMBeR
6(oL\ "
WHER" PURCHASED
PURCHASED AS
. 'C:f:) 0 NEW licJ1USED
WIOTH LENGTH WEIGHT
lto FT. ~FT.
COlOR NO. OF AXLES
BATHS_
DOeS MOBILE HOME HAVE
o SKIRTING
o Al~ CONDmON1NG
o DISHWASHER
SIGNATURE OF MOall.E HOME OWNER
_SF
_SF
__SF
BDRMS. _
o FIREPLACe
o WASHER
o DRYER
TOTAl ROOMS
1. Total Fair Market Value $
2. Exempt Furnishings _ $
3. NET FAIR MARKET VALUE $
(Subtraclline 2 from line 1)
SIGNATURE OF ASSESSOR
4. Net Fair Market Value (from line 3 above)
$
The tirst monthly fee
covers the month of
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) $
(Enter month)
and is due on or before
the 10th day of
(Enter the foUowtng month)
The monthly fee Is due
on or I?efore the 10th
day of each month
thereafter.
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WIaoontIn o.putmenl of ~""