HomeMy WebLinkAboutSeptember 8, 2006 RECEIVE:
MOBILE HOME STATEMENT OF MONTHLY PARKING PERtfaT f :
INSTRUCTIONS ASSESsoRs OPF,Ca
OSHKOSH, WISCONSIN
MOBILE HOME PARK OPERATOR (or owner of land if mobile home subject to fee 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 Home Valuation
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.
CLERK: Complete Section C.
SECTION A
TAXATION DISTRICT SCHOOL DISTRICT COUNTY NAME OF OBILE HO E WNER
w in NAME OF PARK SOF OBILE HOME .
TO BE /� Y Q - 01 G, So.() n V i
COMPLETED PARK ADDRESS ARRIVAL DATE OWNER PERMANENT ADDRESS
BY 91 ao 5
PARK MOBILE HOME DESCRIPTION
OPERATOR MANUFACTURER'S NAME MODEL OR POPULAR NAME SERIAL NUMBER
AND O Pc .0 II3b
MANUFACTURE YR OF M� FA PURCHASE YEAR PURCHASE PRICE PURCHA S W RE PU CHASED
/
MOBILE i ba (O E NEW U ED rI
HOME DO YOU HAVE LICENSE NO. (IF APPLICABLE) WIDTH LENGTH WEIGHT COLOR NO. OF AXLES
OWNER 0 BILL OF SALE 0TITLE �
FT. FT.
NO. OF ROOMS DOES MOBILE HOME HAVE
BATHS BDRMS ❑ SKIRTING 0 FIREPLACE 0 PORCH SF
0 AIR CONDITIONING 0 WASHER 0 PATIO SF
TOTAL ROOMS 0 DISHWASHER 0 DRYER 0 CARPORT SF
PLEASE S TURF OF MOBILE HOME OWNER ^ � DAT9 J c)(40
SIGN HERE
SECTION B — VALUATION
DATE VIEWED OR INSPECTED
ASSESSOR 1. Total Fair Market Value $
2. Exempt Furnishings — $
3. NET FAIR MARKET VALUE $ SIGNATURE OF ASSESSOR
(Subtract line 2 from line 1)
SECTION C - COMPUTATION OF PARKING PERMIT FEE
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 line 5) .... $
CLERK 7. Net Tax Rate (after state tax credit) and is due on or
before 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
10. Lottery Credit (if applicable) —$ due on or before the
11. Net Monthly Fee (subtract line 10 from line 9) $ 10th day of each
month thereafter.
PA -118 (R. 12-04)
Wisconsin Department of Revenue