HomeMy WebLinkAbout1981PLEASE MAll. REPORT TO:
State of New York
Department of Audit and Control
Division of Municipal Affairs
Bureau of Municipal Research and Statistics
Governor Alfred E. Smith State Office Building
Albany, Now York 12236
ANNUAL REPORT
OF THE
NAME OF DISTRICT
TOWN OR TOWNS OF
COUNTY OF
FIRE
YEAR ENDED DECEMBER 31,
174 r r/ 'x C
IN THE
,~?0 z.c T H OLD
x~L~_ FF 0/-. K
DISTRICT TREASURER
b
~-r~ ~ C T,
THE DISTRICT IS GOVERNED BY: (chock one)
Separate Board of Fire Commissioners
or
[] Town Board
AUTHORIZATION
Article 3, Sect/on 30, of the General Municipal law
"1. *** every *** fire *** district *** shall annually make a report of its financial condition to the comptroller.
Such report shall be made by the *** treasurer of each fire *** district ***"
"5. All reports shall be certified by the officer making the same and shall be filed with the comptroller within
sixty days after the close of the fiscal year of such *** district ***"
CERTIFICATE OF FIRE DISTRICT TREASURER
(Please Print or Type)
Fire District and that the following report is a true and correct statement of the financial transactions
of such Fire District for the year ended December 31, 19.~..~.
AC 1962 (11/78)
Print Code YZ
STATE OF NEW YORK
/:)-de",
DEPARTMENT OF AUDIT AND CONTROL
GENERAL
EDP
RECEIPTS AND BEGINNING BALANCE Code
Al0 Real Property Taxes(sameastaxcomputationonpage4) .... A1001
A20 State Aid for Loss in Railroad Tax Revenue .................. A3007
A30 Federal Aid for Civil Defense ...................................... A4305
A40 Charges for Fire Protection, Other Services .................. A2262
A51 Interest and Earnings .................................................. A240t
A52 Rentals ...................................................................... A2410
AS3 Sale of Equipment ...................................................... A2665
AS4 Gifts and Donations .................................................... A2705
ASS Refunds of Expenses .................................................. A2701
A59 Miscellaneous Revenues (specify)
.............. A2770
A81 Transfer from Capital Fund ........................................ A2850
A82 Transfer from Reserve Fund ........................................ A2882
Total Revenues ....................... · .......................... AS000
A64 Budget Notes Issued .................................................. A5750
A65 Tax Anticipation Notes Issued .................................... A5760
A66 Revenue Anticipation Notes Issued .............................. A5770
Total Notes Issued ............................................
A90 Sale of Investments .................................................... 'A5085
Total Receipts ................................................ A6000
Balance at Beginning of Year ...................................... A8501
TOTAL RECEIPTS AND BALANCE .............. A8599
PAYMENTS AND ENDING BALANCE .,
Al00 Personal Services ....... /..~.~.~.~.Q..~. .......... A3410.1
A200 Equipment ~. ~4 j~.~. ~.~.~ .~/~....~.' · .~ · .~. · .~. ~. ......................
A3410.2
A400 Contractual and Other Expenses .................................. A3410.4
A601
A602
A603
A610
A628
A629
A630
A633
A636
A638
A680
A681
A690
A691
A801
A802
A900
Hydrant Rental ............................................................ A3410.4
Fire Department or Company Services .......................... A3410.4
Fire Protection .......................................................... A3410.4
Judgments and Claims ................................................ A1930.4
State Retirement System .............................................. A9010.8
Police and Fire Retirement System .............................. A901§.8
Workmens Compensation Insurance .~.'~¢.~'.~..'~..~..~..~'. ....... A9040.8
Social Security ............................................................ A9030.8
Medical, Surgical and Hospital Care .............................. A9060.8
Insurance''~./¥i~-~/.?,~.)~.'.~.Z]~'~'.?' ...... A9060.8
B~,~t
Interest on Bends ........................................................ A9710.7
Interest on Nates ........................................................ A9729.7
Redemption of Bonds .................................................. A9710.6
Redemption
Transfer to
Transfer to
Total
Purchase of Investments
Other (specify)
of Notes .................................................. A9729.6
Capital Fund ............................................ A9§50.9
Reserve Fund ............................................ A9 560.9
Expenses .................................................. A9900.0
.............................................. A9985.5
Total Payments .............................................. A9999.0
Balance at End of Year (Transfer to page 4) .................. A8507
TOTAL. PAYMENTS AN~D BALANCE ............ 'A8599.0
FUND
NOTE: EDP Codes are for Department of Audit and Control use.
^c ~ges I~,nsI
Print Code X ANNUAL REPORT OF NOTICES OF TORT CLAIMS
F,sc^. EA.
Name -o ~ Mu~icipaP. ity)
COUNTY
L
Claims Pending at Beginning of Year
Notices of Claims Filed During Year
NUMBER
Claims Disposed of During Year Prior to
Commencement of Court Action:
4a By Municipality
4b By insurance Carrier
Claims Disposed of During Year After
Commencement of Court Action:
Sa By Municipality
Sb By Insurance Carrier
Sc By Judgment
Other (explain)
to
NUMBER
TOTAL
Number Amount Amount Paid
of of on
Claims Claims Claims
XXXX
XXXX
$ S.
6a
7 TOTAL CLAIMS DISPOSED OF DURING YEAR
8 Claims Pending at End of Year (Line 3 minus line 7)
AUTHORIZATION
Article 4, Section SO.f of the Genera/Municipal /aw
m mXXX.
3. a. Each officer charged with the duty of making and keeping the record of claims shall make an annual report thereof, in summary,
to the governing board of such municipal corporation or of such authority or commission and shall file a copy thereof in the office of the
state comptroller within sixty days after the close of the fiscal year of such municipal corporation or of such authority or commission. A
· municipal corporation, authority or commission required by section thirty of the general municipal law to file an annual report of its finan-
cial condition with the state comptroller shall file the report required by this subsection with such financial report.
XXXem.
Dated:
Note:
Title
Itq4'~ not necessary to furnish any additional information or details of the above claims or notices of claims.
If there were no notices of Tort Claims filed or disposed of, please state *'NONE" and return this repmt with the Annual Financial
Report.
DEPARTMENT OF AUDIT AND CONTROL
DIVISION OF MUNICIPAL AFFAIRS
ALBANY, NEW YORK 12236
FUND
EDP
RECEIPTS AND BEGINNING BALANCE Code
H51 Interest and Earnings .............................................. H2401
H60 Bonds .................................................................. H5710
H61 Premium and Accrued Interest on Bonds .................. N2710
H62 Capital Notes ........................................................ H5740
H63 Bond Anticipation Notes ........................................ H5730
H82 Transfer from General Fund .................................... H2810
Other .................. H 2770
Total Receipts .............................................. H6000
Balance at Beginning of Year .................................. N8491
TOTAL RECEIPTS AND BALANCE ............ H8499
H 200
H $00
H693
H810
PAYMENTS AND ENDING BALANCE Equipment ............................................................
Real Property (include interest during construction) ....
Redemption of Bond Anticipation Notes ....................
Transfer to General Fund ........................................
Other ..................
Total Payments ............................................
Balance at End of Year(Transfer to page 4) ..............
TOTAL- PAYMENTS AND BALANCE ............
H3410.2 $
H3410.3
H9930.5
H9510.9
H9995.5
H9999.0
H8497
H8499.0
RESERVE
RECEIPTS AND BEGINNING BALANCE
MS1 Interest and Earnings ..................................... ~.~.,.~,~ R2401
M53 Sale of Assets ...................................................... R2660
M82 Transfer from General Fund ...................... .~..0~1.,.(-~(-,) R2810
M83 Transfer from Reserve Fund .................................... R2882
Other
Total Receipts ..........................
Balance at Beginning of Year .....................
RECE,PTS AND BALA. CE
TOTAL
PAYMENTS AND ENDING BALANCE
M200 Equipment ..............................................
MS00 Real Property ........................................................
M802 Transfer to Reserve Fund ......................................
M810 Transfer to General Fund ......................................
FUND(S)
' 'r'y'pe (pu~'p~s;)'of'Reserve
s Y623q
'1(/pe~(pur~se) ~f Re~serv,
R2770
R ooo s I /
R8499 / a '1 '
R3410.3
R9560.9
R9S10.9
R9995.5
OtherTotal Payments " ........................ iiiii~¢~:~:i:':~R9999'0 $' ~---- $_-~~~~/~
Balance at End of Year (TransCer to pa~, 4) .....~.[,..0"~ R8497
TOTAL,PAYMENTS AND BALANCE ~,.~R8499.0 ~~--== $~~%~_ _ .
TRUST AND AGENCY FUNDS
T2 New York State Income Taxes .. T21
T3 Federal Income Taxes ............ T22
T4 Social Security Taxes ............ T26
TS Foreign Fire Insurance Fund .... TS0
T6 Group Insurance Deductions ...... T20
Other (specify)
.... T85
.... T85
TOTALS .......................... T808
Cash Balance Cash Balance '
Beginning of Year Cash R-.ceipts Cash Disbursements End of Year
RECONCILIATION OF CASH AND BANK BALANCES
Cash Balances by Fund at End of Year:
General Fund (from page 2) ......................................................................................................
Capital Fund (from page 3) ......................................................................................................
Reserve Fund (from page 3) ....................................................................................................
Trust and Agency Funds (from page 3) ......................................................................................
Total- All Funds ..............................................................................................
Bank Balances at End of Year:
_ Name and Location of Bank _ Bank Balance Outstanding Checks
TOTALS $- $
Petty Cash ..........................................................................................................................................
Cash on Hand (Dale Deposited __) ..............................................................
TOTAL BANK BALANCES AND CASH ON HAND ................................................ 8300 ................
INVESTMENTS HELD AT DECEMBER 31, 19
Net Bank Balance
/,?
Fund Description of Investment Purchase Price
$
TOTAL INVESTMENTS ................................................................................' ...... 8531 ...... $
COMPUTATION OF REAL PROPERTY TAXES
Town
Assessed Valuation
of Fire District
Within Town
2
Tax Rate
per $1,000
of Assessed Valuation
Amount of Tax
(Assessed Valuation
Multiplied by Tax Rate)
DISTRICT TOTAL 855. tS :~ $ *
* Must agree with Real Property Taxes shown at top of page 2. TOTAL ASSESSED VALUATION $
DETAILED STATEMENT OF INDEBTEDNESS
J I I Outstanding I Issued Redeemed ' Outstanding
Bonds r Year ] Interest J Beginning [ During During End
(Show each issue separately by of ~ . I
Title and Purpose) /' Issue ! Rate[ of 1Year I Y~ar YTr of ;ear
....................... -t- ........ t-- l, .... I, ..... ....
TOTAL BONDS OUTSTANDING AS OF DECEMBER 31 $
Notes
Tax Anticipation Notes 891. X___X_X._X_ -'-~-~X
Revenue Anticipation Notes 892. XX__.___~XX
Budget .o,es 893. _X_X__X_X_ i ' -X_ _X_ X__
Capital Notes 895. X_~XX___X_ . XX__X J
Bond Anticipation Notes 896. _XX___X_X XXX
TOTAL NOTES 821. XXXX XXX $ $ $
TOTAL NOTES OUTSTANDING AS OF DECEMBER 31 $
RECEIVABLES CLAIMS PAYABLE
Amount Due District at End of Year 8532 $ ~ . Amount of Unpaid Claims of District at Endof Year 8541 $
DO NOT FILE THIS REPORT IF $100.00 OR LESS WAS RECEIVED
ANNUAL REPORT
ON
RECEIPT AND DISBURSEMENT OF FOREIGN FIRE INSURANCE PREMIUMS
(NAME AND TYPE OF ENTITY)
.Town Cle~ Southold
Balance:
Receipts:
Total
(NAME OF MUNICIPALITY OR DISTRICT WHERE LOCATED)
,,,vTz--'~:.~- o.J ~.'~,~ $ i1~. O'T~
Balance and Receipts
Disbursements:
Purpose Amount
_~ ii/z--l--
Balance:
(DATE - END OF YEAR)
(SEE INSTRUCTIONS ON REVERSE SIDE)
$ Mb-/,
~6 7~., om
I, ~z:O~Z: '/'~,.. Ix&O0m~/-/z~// , certify that this report is a true and
accurate statement of the receipts and disbursements of foreign fire
insurance premiums for the year ended
(DATE)
'"-" (SIGNATURE) (ADDRESS)
(TITLE)
(T'EL~'~'HONE NUMBER)
Please mail
report to:
ATTENTION: Nicholas Solomos, Associate Examiner
New York State Department of Audit & Control
Division of Municipal Affairs
State Office Building
Albany, New York 12236
FILING INSTRUCTIONS:
1. The "beginning" balance should agree with last years "ending"balance.
2. Any interest earned by investment (placing in savings account,
certificates of deposit, etc.) of the foreign fire insurance tax
moneys should be included in receipts. Identify by major category.
3. Purpose of disbursements should be clearly stated in general terms
(recreational equipment; annual picnics; annual Christmas party, etc.).
4. "Ending" balance should be balance on hand as of December 31.