The owner, lessee, or manager of land upon which is parked or located a mobile home, shall report by January 15 of each year to the county assessor, upon forms sent by the county assessor, in the county in which such land is located all mobile homes located thereon as of January 1 of each year, the year, make, model, and size of each mobile home, the name, post office address of the owner or occupant thereof, and the date the mobile home was first parked or located on such land. Failure to make any report required by this section shall result in cancellation of the permit issued and forfeiture of the fee paid pursuant to section 77-3707.