Form Ptr-2b - Mobile Home Owners-Verification Of 2002 Mobile Home Park Site Fees Page 2

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Form PTR-2B – Instructions
Part I – To Be Completed By Applicant
Social Security Number. If your marital status as of De-
Mobile Home Park Site Number. Enter the mobile home
cember 31, 2002, was single, you must enter your social
park site number of the principal residence for which you
security number in the space provided on Form PTR-2B.
are claiming the reimbursement in the space provided.
If your marital status as of December 31, 2002, was mar-
A. Multiple Occupants. Check “Yes” only if you occu-
ried, you must report both spouses’ numbers in the order
pied your mobile home with someone else (other than
in which the names are listed on the application. If you
your spouse) and shared mobile home site fees with
were married but living apart from your spouse, and you
them. For example, you live in your mobile home with
do not have access to or receive support from your
your sister. If you (and your spouse) are the sole oc-
spouse’s income, you are considered “Single” for pur-
cupant, check “No.”
poses of the property tax reimbursement and you should
enter only your social security number on Form PTR-2B.
B. Share (Percentage) of Site Fees Paid. If you an-
swered “Yes” to Question A, enter the share (percent-
Name and Address. Print or type your name (last name
age) of the site fees that you (and your spouse) paid.
first) and complete address of the property for which you
For example, if you and your sister live in your mobile
are claiming the reimbursement in the spaces provided.
home and you both pay one-half of the site fees, you
Also include your spouse’s name if filing jointly.
must enter 50% as your share. If you (and your
spouse) are the sole occupant, check “No.”
Part II – To Be Completed By Mobile Home Park Owner or Manager
Compare Lines 1 and 2.
Enter the appropriate amounts for calendar year 2002
as follows:
• If Line 1 is equal to Line 2, complete the certification
Line 1. Enter the amount of site fees due under the
portion of Form PTR-2B.
mobile home park agreement entered into with the
• If Line 1 is not equal to Line 2, the applicant is not eligi-
resident(s).
ble for a property tax reimbursement. Do not com-
Line 2. Enter the total amount of mobile home site fees
plete the certification portion of Form PTR-2B.
paid by, or on behalf of, the resident(s). Enter only
Certification. Complete the certification portion of Form
amounts actually due and paid for the calendar year.
PTR-2B.
Part III – To Be Completed By Applicant
Line 3 - Total Number of Residents. Enter the total
Line 5 - Share (Percentage) of Site Fees Paid. Enter
number of residents who lived in your mobile home and
your share (percentage) of site fees paid from Part I, Line
shared site fees. If you are filing a joint application with
B for the calendar year. Enter this number as a decimal.
your spouse, you and your spouse count as one resident.
For example, if you lived in your mobile home with your
sister and you both paid 50% of the site fees, enter 0.50
Line 4 - Total Site Fees Paid. Enter the total site fees
on Line 5. If you (and your spouse) were the sole occu-
paid by all residents who lived in the mobile home for
pant, enter 1.00.
which you are claiming a property tax reimbursement.
(Enter amount from Part II, Line 2.)
Line 6 - Total Site Fees Paid By Applicant. Multiply the
amount on Line 4 by the decimal on Line 5 and enter the
result in the box at Line 6.

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