HomeMy WebLinkAboutMarch 18, 2005 MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE 11
INSTRUCTIONS
MOBILE HOME PARK OPERATOR (or owner of lend if mobile home subject to lee 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 th h me. (Use PA -117, Mobile Home Valuation
Worksheet). NOTE: Exempt furnishings must be d fro v ue if included in R3EtatitiAtERAIM it form to local Clerk
for computation of parking permit fee. =r; -
MAR 2 8 2005
CLERK: Complete Section C. MAR 2 9 2005
ASSESSORS OFFICE
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TAXATION DISTRICT . J v ... P __t r. 7' • BILE HOME OWNER
• City of Oshkosh Nancy Netys
TO BE NAME OF PARK ADDRESS OF PARK
COMPLETED Patrician Village 1951 Vir.inian
COUNTY ARRIVAL DATE '• • RESS • ■ •T= ILE • •
BY Winnebago 04/01/05 1108 Magnolia Avenue
PARK MOBIL - • •
MANUFACTURER'S NAME MODEL OR POPULAR NAME SERIAL NUMBER
OPERATOR Wick Rollohome R36581 1
YR OF MANUFACTURE YR. OF PURCHASE PURCHASE PRICE PURCHASED AS WHERE PURCHASED
AND 1986 2005 $25.900 ❑ NEW at USED Oshk sh, WI
MOBILE DO YOU HAVE LICENSE NO. (F APPUCABLE) MOTH LENGTH WEIGHT COLOR NO. OF AXLES
❑ BILL OF SALE ❑ ME 16 FT ' 80 FT
HOME NO. OF ROOMS DOES MOBILE HOME HAVE
OWNER BATHS 'L BORMS. 3 ❑ SKIRTING ❑ FIREPLACE ❑ PORCH SF
❑ AIR CONDITIONING ❑ WASHER ❑ PATIO SF
TOTAL ROOMS ❑ DISHWASHER ❑ DRYER . s ❑ CARPORT SF
PLEASE SIGNATURE OF MOBILE HOME OWNER DATE
SIGN HERE ///• Ai dir . 4 . LI... I ; CD --
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DATE VIEWED OR INSPECTED
1. Total Fair Market Value $
ASSESSOR
2. Exempt Fumishings — $
SIGNATURE OF ASSESSOR
3. NET FAIR MARKET VALUE $
(Subtract line 2 from line 1)
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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 Computation (multiply line 4 by fine 5) $
CLERK and is due on or before
7. Net Tax Rate (after 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 month)
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
Fee (subtract line 10 from line 9) $ day of each month
11. Net Monthly ( ) thereafter.
Da •'? 'Q 09.92) Wisconsin Department of Revenue