HomeMy WebLinkAboutMobile Monthly Parking Permit MOBILE HOME STATEMENT OF MONTHLY PARKING PERMIT FEE //1 RECEIVED
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INSTRUCTIONS �P 4. ` . '''.•
MOBILE HOME PARK OPERATOR (or owner of land if mobile home subject to fee is located outside of park): Comp iAi � .b
home owner. Submit in duplicate to your local Assessor within 5 days of the arrival of each mobile home. A55�5aCRS CFFICE
ile
ASSESSOR: Complete Section B. Determine the fair market value of the mobile home. (Use PA-117,Worksheet). NOTE: Exempt furnishings must be subtracted from the fair market value if included in that figueHS Submit to local C
for computation of parking permit fee.
Jerk
CLERK: Complete Section C.
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TAXATION DISTRICT -.-�... . :._._. Y-.s..-...._< �. �.::•.- ic, - �_'_?�:a,-tea.. m`'`ss+`` - 4 -
SCHOOL DISTRICT °...:'.` - -: .
City of Oshkosh NAME OF MosILE HOME OWNER
TO BE NAME OF PARK Carol Frank
ADDRESS OF PARK
Patrician Village
COMPLETED 1951 Virginian Street
COUNTY ARRIVAL DATE
BY Winnebago 1001 2012 ADDRESS OF MOBILE HOME
1312 Indigo Drive
PARK MOBILE HOME DESCRIPTION
MANUFACTURER'S NAME MODEL OR POPULAR NAME
OPERATOR Liberty SERIAL NUMBER
YR OF MANUFACTURE PURCHASE YR PURCHASE PRICE PURCHASED AS 06-L-23910
AND 1992 WHERE PURCHASED
2012 $29,500.00 ❑NEW BUSED Flood Homes, Inc
MOBILE DO YOU HAVE LICENSE NO.(IF APPLICABLE) WIDTH
❑BILL OF SALE ❑ TITLE LENGTH WEIGHT COLOR
NO.OF AXLES
HOME 16 F 80 Fr
NO.OF ROOMS , DOES MOBILE HOME HAVE
OWNER BATHS l DORMS G3. RTING
G� ,�,� ❑ FIREPLACE ❑ PORCH SF
Ka IR CON°mONING ❑WASHER ❑ PATIO
TOTAL ROOMS ❑ DISHWASHER Sr
❑DRYER ❑ CARPORT
PLEASE SIGNA I ,OF MOBILE HO.. _ R SF
/
SIGN HERE !/ DATE
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DATE VIEWED OR INSPECTED _..:..x>.:s..
1. Total Fair Market Value $
ASSESSOR
2. Exempt Furnishings —$
3. NET FAIR MARKET VALUE $ SIGNATURE OF ASSESSOR
(Subtract line 2 from line 1)
4. Net Fair Market Value(from line 3 above) $ The first monthly fee
5. % Level of Local Assessment X covers the month of
(established for preceding Jan. 1 assessment)
6. Value for Fee Computation(multiply line 4 by line 5) $ (Enter month)
CLERK
7. Net Tax Rate(after state credits) and is due on or before
(established for preceding January 1 assessment) X the 10th day of
8. Annual Fee (multiply line 6 by line 7) $
9. Gross Monthly Fee (divide line 8 by 12 months) $ (Enter the following month)
10. Lottery Credit(if applicable) The monthly fee is due
—$ on or before the 10th
11. Net Monthly Fee(subtract line 10 from line 9) $ day of each month
thereafter.
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PA-118(R.09-93)
Wisconsin Department of Revenue