HomeMy WebLinkAboutDecember 17, 2007
MOBilE HOME STATEMENT
INSTRUCTIONS
MOBILE HOME PARK OPERA TOR (Of cwnef 01 land il mobile home subject to lee is located ?utsids 01 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 Home Valuation
Worksheet). NOTE: Exempt furnishings must be subtracted from the fair market value if incfuded in that figure. Submit form 10 local ClerK
for computation of parking permit fee. RECEIVED
CLERK: Complete Section C.
TO BE
COMPLETED
BY
PARK
OPERATOR
AND
MOBILE
HOME
OWNER
DEC" 2 1 2007
TAXATION DISTRICT
City of Oshkosh
NAJ.IE OF PARK
Edison Estates
"-~\\a,
ADDReSS OF P
31- S \ C~ \ en""
ADDReSS OF UOBILE HOUE
. . ~ \0
MOBILE HOME DESCRIPTION
LlOOEl. OR POPUl..AR NoWE
COUNTY
Winnebago
l.IANUFACTURER'S HALlE
G\0S\\-~
YR OF UANUFACTUR
OTlTtE
LENGTH
(4 FT. fO FT.
NO. OF AXLES
DUes JJOBILe HOME HAVE
BDRUS. _ 0 SKIRTING
o AIR CONDITIONING
TOTAL ROOUS 0 DISHWASHeR
SIGNATURE OF MOBILE HOJJE OWNeR
o FIRepl.J,Ce
o W.ASHEn
o DRYER
o PORCH
o PATIO
o CARPORT
SF
SF
SF
1. Total Fair Market Value $
ASSESSOR -$
2. Exempt Furnishings SIGNATURE OF ASSESSOR
3. NET FAIR MARKET VALUE $
(Subtract line 2 from line 1)
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) (Enter month)
6. Value for Fee ComputatIo~ (multiply line 4 by line 5) $
CLERK Net Tax Rate (after state ~~edits)' and is due on or before
7. the 10th day ot
(established for preceding January 1 assessment) X
8. Annual Fee (multiply line 6 by line 7) $ (Enter the lollowing month)
$ ,
9. Gross Monthly FeG (divide line 8 by 12 months) ..... The monthly fee is due
-
10. Lottery Credit (if applicable) -$ on or before the 10th
d.ay of each month
11. Net Monthly Fee (subtract line 10 from line 9) $ thereafter.
I' (R. 09-921
UIt___~I_ f"\.__.___ -' n_.__u.