2001
to be filed in 2001
Iowa Mobile/Manufactured/Modular Home
I O WA
Owner Application For Reduced Tax Rate
d e p a r t m e n t o f R e v e n u e a n d F i n a n c e
Claimants Last Name
Claimants First Name
Claimants Social Security Number
Claimants Birth Date
County Number
/
/
/
/
Spouses First Name
Spouses Social Security Number
Spouses Last Name
Month
Day
Year
____
____
/
/
Street Address
City, State, Zip Code
p
Do Not Write In This Space
YES NO
2000 Household Income
Use Whole DOLLARS Only
0 0
,
.
0
0
,
.
0
0
,
.
0 0
,
.
0
0
,
.
0
0
,
.
0
0
,
.
0
0
,
.
0
0
,
.
0
0
,
.
0
0
,
.
This is your total household income
penalty of perjury
For Use by County Treasurer Only
Sq. Footage ________________________________
Income
Reduced
Year of manufacture _________________________
Tax Rate
If year of manufacture is 1992 -1995,
$ 0.00
-
8,686.99
0
apply 90% factor.
If year of manufacture is 1991 or before,
8,687
-
9,708.99
.03
apply 80% factor.
9,709
-
10,730.99
.06
Regular Tax ________________________________
10,731
-
12,774.99
.10
Reduced Tax _______________________________
12,775
-
14,818.99
.13
14,819
-
16,862.99
.15
Reimbursement _____________________________
This claim must be filed with your County Treasurer by June 1, 2001, unless the treasurer extends the filing deadline to September 30,
2001. The Director of Revenue and Finance may extend the time for filing through December 31,2001.
54-014a 11/22/00