HomeMy WebLinkAboutMay 12, 2006 MOBILE HOME STATEMENT RECEIVED
INSTRUCTIONS MAY 1 26
j ASSE E SSORQ
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MOBILE HOME PARK OPERATOR (or owner 0! land,! mobile home subject to fee Is located outside ofpark) :• %Me fO1900.6 h 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.
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TAXATION DISTRICT •• NAME OF MOBILE 140M - OWNER
City of Oshkosh r- , 1. O l x �L4eC
•
TO BE NAME OF PARK ADORESS •F PARK ��
Edison Estates —3 —IN 6.)k _ i re,
COMPLETED COUNTY ARRIVAL DATE ADDRESS OF MOBILE HOME 1 '��
BY Winnebago Lk I
PARK I M ILE HOME DESCRIPTION
LIANUFACTUREWSINAME 400EL OR POPULAR NAME SERIAL NUMBER
OPERATOR a-11" A - P'sq t4..4%
AND
ii 11
YR OF l.1/�IUFARE YR. Of PURCHASE PURCHASE PRICE PURCHASED AS WHERE PUR EO
`(_-'��` 1 P p co jj0 / ` J� `�� (U
O NEW SED pa)
MOBILE 00 YOU HAVE LICENSE NO. (IF APPLICWE WIDTH LOOT. ENGTH l WEIGHT COLOR N0. AXLES
• HOME ❑ BILL OF SALE ❑ Tm,E 1 Fr '
NO. OF ROOMS CUES 4081LE HOME HAVE
OWNER BATHS SOMAS. ❑ SKIRTING ❑ FIREPLACE ❑ PORCH SF
0 MR CONDITIONING ❑ WASHER ❑ PATIO SF
TOTAL ROOMS 0 DISHWASHER ❑ ORYER ❑ CARPORT SF
PLEASE SIGNATURE OF MOBILE HOME OWNER ��-(� r OATS • SIGN HERE C ^ � . " ' " ' on
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OATE VIEWED OR INSPECTED
1. Total Fair Market Value $
ASSESSOR
2. Exempt Furnishings — $
1 SIGNATURE OF ASSESSOR
3. NET FAIR MARKET VALUE $
(Subtract linen from line 1)
7s # L { <� ��.a�e ?� £: o� ‘:..4,-.-64..., ti t,iy.,�;. -..r 1 t ., +++T t
r • r2G •'
4. Net Fair Market Value (from line 3 above) $ The first monthy fee
5. 9 Level of Local Assessment X
covers the month of
(established for preceding Jan. 1 assessment)
(Ente( month)
6. Value for Fee Computation (multiply line 4 by line 5) S
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) $ -..,t
The monthly lee is due
10. Lottery Credit (if applicable) — $ on or before the 10th
day of each month
• 11. Net Monthly Fee (subtract line 10 from line 9) $ thereafter.
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