Form S4-014 - Iowa Mobile / Manufactured / Modular Home Owner Application For Reduced Tax Rate (2000)

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IOWA MOBILE / MANUFACTURED / MODULAR HOME
2000
OWNER APPLICATION FOR REDUCED TAX RATE
To Be Filed in 2000
First Name
Claimant's Last Name
Claimant's Social Security Number
Claimant's Birth Date
County
Number
Spouse's Last Name
First Name
Spouse's Social Security Number
Month Day Year
Street Address
City, State, Zip Code
Do not write in this space
Were you 23 years of age or older on 12/31/99?......................................................................
Yes
No
Use Whole DOLLARS Only
1999 Total Household Income
0 0
1. Wages, salaries, tips, etc.
0 0
2. In-kind assistance for housing expenses
0 0
3. Title 19 Benefits (excluding medical benefits)
0 0
4. Social Security income
0 0
5. Disability income
0 0
6. All pensions and annuities
0 0
7. Interest and dividend income
8. Profit from business and/or farming and capital gains
If less than zero enter 0 (see instructions)
0 0
9. Actual money received from others living with you
(See instructions)
0 0
10. Other income (Read instructions before making this entry)
0 0
11. ADD amounts on Lines 1-10, enter here
0 0
(If $16,665 or greater, no credit is allowed)
This is your total household income
I declare under penalty of perjury that I have reviewed this claim and to the best of my knowledge and belief,
it is true, correct, and complete.
(
)
Claimant's Signature
Date
Telephone Number
For Use by County Treasurer Only
Reduced
Income
Sq. Footage _______________________
Tax Rate
$ 0.0 - 8,584.99
Year of manufacture _________________
0
If year of manufacture is 1991 -1994, apply
8,585 - 9,594.99
.03
90% factor.
If year of manufacture is 1990 or before, apply
9,595 - 10,604.99
.06
80% factor.
10,605 - 12,624.99
.10
Regular Tax________________________
12,625 - 14,644.99
.13
Reduced Tax________________________
14,645 - 16,664.99
.15
Reimbursement______________________
This claim must be filed with your County Treasurer by June 1, 2000, unless the treasurer extends the filing deadline to
September 30, 2000. The Director of Revenue and Finance may extend the time for filing through December 31,2000.
54-014 (8/99) cu

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