HomeMy WebLinkAboutDecember 5, 2007
MOBILE HOME STATEMENT OF MONTHLY PARKINGPER~ ~E ~;~~. Jr.: EO. ,I
INSTRUcnON/\ Q~ r .. .~~C:6ii200.7 !
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MOBIl.E HOME PARK OPERA TOR (or owner of land If mobile home subject to fee Is located outside of pafl()$~DI$lJ~tw~W"sfJ\, with mobile
home owner. Submit In duplicate to your local Assessor within 5 days of the arrival of each mobile home.
ASSESSOR: CompleteSe<:tlon 8. Determine the fair market value of the mobile home. (Use PA-117, Mobile Home Valuation
Worksheet). NOTE: Exempt furnishings must be subtracted trom the fair market value It Included in that figure. Submit torm to local Clerk
for computation of parking permit tee.
CLERK: Complete Section C.
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
ASSESSOR
NAME OF MOBILE HOME OWNER
, :SKue. Sl (\{\.{'\,o(\"?::'
AODRESS OF I.lOBILEHOME...
-. 'i a 2. lJJln
OWNERPERMANENTAOORESS
. .:t:t:- :". ,.
MANUFACTURER'S NAME
!~ ~c"'\-
VR OF M9ANUFA.CTU. E'
\ --=t lP
ka
SEI'llAl NUMBER
Lolol. 101-(.1
WHERI'" PURCHASED
PURCHASE VA PURCHASE PRICE PURCHASED AS
dcr:::r4- 't~-oo~ 0 NEW .tDiSEO
LICENSE NO. (IF APPLICABlE) WIDTH ~GTH WEIGHT
/ L/ FT. Sto FT.
00 YOU HAVE
o BIll. OF SALE 0 nTlE
NO. OF ROOMS
BATHS_ BORMS._
COlOR
NO. OFAxI.ES
TOTAl ROOMS
OOES MOBILE HOME tfAVE
o SKIRnNG
o A1~ CONOmONING
o OIStfWASHER
SIGNATURE OF MOBILE HOME OWNER
_SF
_SF
_SF
o FIREPLACE
o WASHER
o ORYER
1. Total Fair Market Value $
2. Exempt Furnishings _ $
3. NET FAIR MARKET VALUE $
(Subtract line 2 from line 1)
SIGNATURE OF ASSESSOR
CLERK
P....t11 (R. 08-e3)
4. Net Fair Market Value (from One 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)
(establlshedfor preceding January 1 assessment) X.
8. Annual Fee (multiply line 6 by line 7) $
9. Gross Monthly Fee (divide line 6 by 12 months) $
10. Lottery Credit (if applicable) _$
11. Net Monthly Fee (subtract line 10 trom line 9) $
(Enter month)
and Is due on or before
the 10th day of
(Enter the toUowlng month)
The monthly fee Is due
on or I;>efore the 10th
day of each month
thereafter.
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