HomeMy WebLinkAbout1991All Numbers In This Report
Must be Rounded to the Nearest
Dollar
Method of Accounting (Check One)
~/ Single Entry Cash
__Double Entry Modified Accrual
ANNUAL REPORT
FEB 199Z
OF THE
FIRE DISTRICT TREASURER
ENDED DECEMBER 31, 19
TOWN OR TOWNS OF
COUNTY OF
THE DISTRICT IS GOVERNED BY:
IN THE
(Check One)
Separate Board of
Fire Commissioners
/ or Town Board
AUTHORIZATION
Article 3, Section 30, of the General Municipal Law
"1. ***evezy-~**fire~Adistrict~AAshall ~n-ually make a report of its financial condition to the Comptroller.
Such report shall be made by the ~treasurer of each fireX~AdistrictXAx.''
"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~AZdistrictZX~.''
PLEASE MAIL REPORT TO:
State of New York
Office of the State Comptroller
Division of Municipal Affairs
Bureau of Municipal Research and Statistics
Governor Alfred E. Smith State Office Building
Albany, New York 12236
Revised 1991
r~sh
P~tty r~
Tot~l r-mb
~NERAL FU~ - BAL~E SHEET - AS OF
ED~X~E
~
AL~01
A;lO
X~t.mn't in R, ffpurd'~ &gres~nt$
$
St&ts ~ Feckr~l
Simte .nd Fedm~l, other
A4IO
Xnwn~rory
To~l Rsstrio~d Assets
LZ~BXLXTZE$ ~4) FUND E~UXTY
I FOR DOUBLE EHI~Y UNZTS ONLY)
A600 E~
i. orl.~ Li~biliti# ~or~g Liabilities
~. to F..plc,y..' Ibtirs.~t Sysis.
Tot~l __~__,,.ed Li.biliti.
A601 ~
A637
A6~O
A&~X
A630
A690
A631
Abgx
A8~5
A88~
Appr~prii)wd-Enluir~ Ymmr's BucCi A910
Unmppr,cq~ Xa,;ced A911
To'M1 Unreserved
Ft.~d Equi~
TOTAL LXABXLXT/ES Al~ FUND E~UXTY
GENERAL FUND
P~CEIPTS/REVENUES
EDPCODE
Real Property Taxes Al001 $ ~ O~O. /~
Charges for Fire Protection A2262
Interest end Earnings A2~01
Rentals A2~10
Sale of.~r=i'l~nt~.~ A2665
Insurence Recoveries A2680
Refend of g~d~uras
O~her Unclassified Rev~ue
Federal A~d for Civil De~se A~305
Tr~sfers
(2)Budget Notes ISsued ~750
(2)T~ ~t[cipation Notes Issued ~760
(2)Revenue ~/cipation Notes
Issued A5770
TOTAL RECEIPTS/P~VENUES
PAI~BNTS / EXPF~D ITUP, E S
EDP~ODE
Judgments end Cia/ms A1930.4
Personal Services A3410.1
Equipment/Capital Outlay A3410.2
Fire Protection (Contractual) A3410.4
State Retirement System A9010.8
Police end Fire Retire System A9015.8
Local Pension Funds A9025.8
Social Security A9030.8
Workers Compensation Insurence A90~0.8
Life Insurence A9045.8
Disability Insurence A9055.8
Hedical/Accident Insurence A9060.8
(3) Redemption of Notes A97 __.6
Interest on Notes A97 .7
Redemption of Bonds A9710.6
Interest on Bonds., A9710.?
'Trs~fer to Other Funds~ A9901.9
Other (Specify)~g~~ A
TOTAL pAYmENTS/EXPENDITURE S
Fund/Cash (1) Balence at Fund/Cash (1) Balence at
Beginning of Year A8021 ,~,¢,,~, ~6/ End of Year *A8029
**TO'rA .<b
(1) Cash balence for siugle entry units should include cash in checking accounts, t/me deposits, Znvestments end
cash.
(2) Single Entry Units Only.
(3) Only Bond Anticipation Notes end Capital Notes for double entry units.
*For Double Entry Units A8029 ~ust equal Fund Equity on Page 1.
**These must be equal.
2
CAPZTAL PROJECTS FUND - BAL~ICE S~EET - ~ OF
To~l
~ue fr~ Other Ftmds
To~l I~siricted Assets
E~PCO~E
H~O0
H~'01
H391
~10
H~O
H~31
$
*.
LZMXLZTZ£S ~D FUND E~UZTY
Aoor~ad Liabililis
Aoor~d £isbiliti~s
To'tel Liabilities
F~tcl B, ilinoe - Reserv~cl
ErK:u.br~rm~s
Cepit~l Rm~rve
To'MX Reser,~cl
FELmcl BE)lsncm - Unreserved
Uns~proprls~d
To'MX Un~.~ser, vm:l
Fi. rtd Equi~
l~rAL LTABXLZTZES ~ FUND E~JZTY
(FOIl -~---m*LE ENIRY LffIXTS (INLY)
EDPCO0~
H601
H
$
H621
H626
$
H605
H630
#631
H
H69X
HSZ1 $
H911
$
CAPITAL FUND
RECEIPTS/REVENUES
EDPCODE
Interest and Earnings H2401
Prem. and Accrued Int. on Bonds H2710
Other (Specify)
Transfer From general F~nd I{5031
Bonds H5710
(1)Bond Allticipation Notes }15730
Capital Notes ~5740
TOTAL RECE IPT8/REVE~TJES
Fund/Cash Balance at Beg~n-ing
of Year
**TOTAL
H8021
~7.~6o, o
pAYmENTS/EXPEND IT~.ES
Fire Protection
Redemption of BAN's
Transfer to O~her Fund
Other (Specify)
TOTAL PAY~Eb~S/EXPENDITURES
Fund/Cash Balance at End
of Year
**TOTAL
EDPCODE
H3410.2
H9730.6
H9901.9
H
*H8029
$ ~
(1) Single Entry Units Only
*For Doubh Entry Units H8029 must equal Fund Equity on Page 3.
**These must be equal.
RESERVE FUND(S)
(FOR SINGLE ENTRY UIG~TS OHLY,
DOIBLE ENTRY ~I~TS HUST ZNCLUDE
EACH RESERVE ZH ~TE Ftl4))
RECEZPTS
Znterest end Earnings
Sele of Assets
o~her (Specify)
Troffers
TOTAL RECETpTS
~TOTAL RECETPTS AHD BALAHCE
PAYI~NTS
Fire Project,on
Trensfers ~o O~her F~ds
other (Specify)
TOTAL PAYHENTS
Be]4nc~ mt End of year
e~TOTAL PAYNENTS AHD BALAHCE
EDPCOOE
R~401
RE770
P~O$1
R~410. ~
R9901.9
T~e
of Reserve
Type (Purpose)
of ~
$
$
$
$
Type (Purpose)
of R~e~ve
$
must be equ~l.
AGENCY ~ # BAL.~NCE SHEET ~ AS OF ·
Cash
Tim 0eposits
To~l ~th
lnv~tsants
In~sblnt in SKuritiu
SKurities lng Hol-tgigss
Caap. Pl~ Pro~icbr
K~ervica instal Progrlm Assets
EDPCOOE
TA~:O0
TA201
$
TAt50
TA4B1
TA4.,55
TA4.55
TA~&O
TA~I
~ENCY FUND L.ZJI~ZLI"rIES
T~8~
TOTAL ~SSETS $ TOTAL J~ENCY LX~XLXT/ES
~Pr~grm icblnisirlior rshinsd by distriot. N~n progria is ~binistrshd by h disirlct h TE ~ s~mJld be uf~d. See S~rvic~
icoo~ting Program Proc~kJr~ cbiad Septesd~r &, 1990.
6
(F(Xl DOI. BLE ENTRY UN~I~ IX'41.Y )
GEIERAL F/XED ~'~**U~TS ACCtXJI~S # B&LN~E ~IEET ~ AS OF
ZNV~STHENT ~1 GEHERAL FZXED JLSS~TS
Bcmds ~ No~ K1K1
Current AIq)r~prietlars
Gifts K~
S~B A~,d K]LG&
Federal Aid K~K7
TOTAL ZIWESll~ENT TH GEHERAL FZXED ASSETS
~SSET~
Aaou~ts to be provided ~or long-Tern
lnst~llmsnt Purck~ Bd)t
'~_ ~s .nd ¢l~im Ps~ble
O~h~r Lang-Term Debt
M626
84627
M628
N637
N68S
H686
H687
N689
TOTAL AMOUNT AVA~LA~.E ~4E) TO B~ pROVZDED
TOTAL L][~BZLZTIES
8
To~l All F,.mds ......................
Berd~ BeLunc:es mt End of Yemr:
Nmm mci Lo~ti.n of Be~
,.,ALS * /~ F'~4 ~/? *
Cash on Nund IDeto Deposited) .................................................. .. ... -- · .....
IN~ES~ENT~ HELD AT DEL'EI~ER 31, 19 --
F~d n----ip~iofl of lnds~ Purdxmae prloe
*
9
DETAILED STATEHENT OF II~EBTEDNESS
Bonds
(Sho~ each issue separately by)
EDP
Code
Year Outstanding Issued Redeemed Outst&udtns
of Interest Beg~--~-g During During End
Issue Rate of Year Year Year of Year
1 3 5 7
TOTAL BONDS 2P1877 Y~ XXX
I
TOTAL BONDS OUTSTANDING AS OF DECENDER 31 $
Tax tnticipatton Notes 2P1861
Rev~ue Anticipation Notes 2P1862
Budget Notes 2P1863 ~ XXX
Capital Notes 2P1875
~ond ~ticipation Notes 2P1876
TOTAL NOTES OUTSTANDING AS OF DECEHBER 31
TOTAL BONDS tND NOTES
I,-,xx I ~ 19 I~ 19 19
10
Assessed Valuation Tax Rate
EDP of Fire District per 81,000
Code With/nTo~n of Assessed Valuation
Amount of Tax
(Assessed Valuation
Hultiplied by Tax Rate)
~ I I $~:~/? ~6. ~ ] 8 ~, ~/~
*Should ~ree with Receipt of Real Property T~es as sh~ at top of page 1
COHPUTATION OF FULL VALUATION OF TAXABLE ~AT. PROPERTY
Assessed Valuation
of Fire District
WtthinTo~n
Equalization
Rate
Full Valuation
(Assessed Valuation
Dividedby
Equal~zation Rate)
Total Assessed
Total Full Valuation
EDP
Code
9ZF~
~XAI, fl)T.I~ OF CALCUIATION OF FULL VALUATION:
To~n A
To~n B
TmmC
Assessed Valuation
Full Valuation
11
810,000 25% = 840,000
5,000 40% = 12,500
20tO00 100~ = 20tO00
835,000
~72~500
HOT~CES OF TORT CLA~HS
FOR TH~ F~i_t~ YEAR EHDIH6 Z9
TOTAL ~R OF CLAEHS
EDP COOE HIO~R
TOTAL AHOL~T OF CLA~HS
TOTAL AIIOUNF PAID 014 CLA~S
EDP CG~E AHOUNT EDP CCOE Nf~JNT
Claims Po~ding - Beginning of Your
Involvi~ Codo~eflchfl~/Third Party Dofefldmt ~ZTRIO
O~or Cl-ims 9ZTR2~
Notices Filed Du~ir~ b Ymr
claim di~ o~ ~ ~ ~r
- By ~li~ 9~0
Chh di~ of ~ h ~r
afbr ~ of ~t ~*i~:
- By ~li~ ~
- By l~ ~rri~ 9~0
- By ~* 9~70
- O~r ( ) 9~
4
9~rR3z 9Zl'R3S, B
9~X 9ZTR42
9ZTR6X 9ZTR62 8
9Z1~7~ 9ZFR72 9
9Z1RSX 9ZTR82 10
Equals:
Claim ;)ending - End of Yo~r
lnvolviflo Codofefldmt/fl~ird Pir~y Dofeflduflt
9ZTR~O
X!
Ohr claims 9Z'1'~9S 9~qli9~
12
14)TZC~S OF TORT C:LAZHS
FOR TIE F'Z~CAL YE&R EN~ZNB 19 ~
(1) (~')
EDI~OOE HU~ER EDPC:~E I,k~i~ipeli*'L~'8 ECl~bd~,le hre EDPCGOE
OF CLAZHS
(3)
,M~JJT PAZO GREATER TflAH E~I~TABLE SHARE
7 ~ ~ m
8 9ZTR&4 9ZTR6& 9ZTR68
9 O'~'R7~. 9Z'1~76 9ZTR78
10 ~ 9ZTROG 9Z'rR~8
eeport pr~pmred By:
ehon~ lamber
Title
13
CERTIFICATE OF FIRE DISTRICT TREASURER
(Please Print or Type N~me)
Fire District and that the following report is a true and correct statement of the f/nancial transactions
of such Fire District for the year ended December 31,
Dated
Telephone (~/~
Area
Code
CHAIP~AN OF THE BOARD
Address
Telephone (
Area
Code
STATE OF ~ YORK
OFFICE OF T~ STATE COHPTROT.TAR
14
ALt NUMBERS IN THIS-REPORT HUST BE ROUNDED TO THE ~ .DOLLAR
ANNUAL REPORT ON
REVENUES AND EXPENDITURES OF FOREIGN FIRE INSURANCE PREMIUMS
(NINE AND TYPE OF E~TITY)
MAHE OF TOI/N OR CITY I~rlERE LOCATED NAHE 6 RE LOCATED
NAHB OF DISTRICT WHERE LOCATED (IF APPROPRIATE)
For the Fiscal Year Ended /oqT/~//~/ (Date)
Balance:
Revenues:
(Date - Beg. of Year)
Foreign Fire Ins.
Other Revenues
Total Revenues
Total Balance and Revenues
Expenditures:
EDPCODE A~OUNT
16P8021 ............... $ ~
16P8022 ............... $.
Total Expenditures
alanc.:
(Date - End of Year)
16P8024'
(SEE ~NSTRUCTIONS ON REVERSE SIDE)
accurate statement of the revenues
pre~iuss for the year ended
(SlONaTURE)
(TITLE)
Please mail report to:
Attention:
,certify that this report is a true and
and expenditures of foreisn fire insurance
~PHO~ ~ER)
Jeffrey MadeJ, Associate Examiner
Office of the State Co~troller
Division of Municipal Affairs
State Office Buildin~
Albany, NY 12236
FILING INSTRUCTIONS:
1. All numbers in this report must be rounded to the nearest dollar.
The "beginning" balance 16P8021 should agree with last year's
'endinE" balance.
Any interest earned by investment (placing in savings accounts,
certificates of deposit, etc.) of the foreign fire insurance tax
moneys should be included in receipts.
Purposes of disbursements should be clearly stated in general
terms (reCreational equipment; annual picnics; annual Christmas
party, etc.).
"Ending" balance 16P8029 should be the cash balance on hand as of
end of fiscal year.
All Numbers In This Report
Must be Rounded to the Nearest
Dollar
ANNUAL REPORT
OF THE
Met~ of Accounting (Check One)
S~-ngle Entry Cash
Double Entry Modified Accrual
FEB 4
FIRE DISTRICT TREASURER
YEAR ENDED DECEMBER 31, 19 %/
IN THE
TH~ DISTRICT IS GOVERNED BY:
(Check One)
Separate Board of
Fire Commissioners
J or Town Board
AUTHORIZATION
Article 3, Section 30, of the General Municipal Law
"1. A~every***fireAZXdistrict~shall annually make a report of its financial condition to the Comptroller.
Such report shall be made by the *~treasurer of each fire~districtAXX.''
"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~'~*districtXXA.''
PLEASE MAIL REPORT TO:
State of New York
Office of the State Co~troller
Division of Municipal Affairs
Bureau of Municipal Research and Statistics
Governor Alfred E. Smith State Office Building
Albany, New York 12236
Revised 1991
TM
~tty C~h
Tot:m1 C~h
GEI~RAL FUND - BALANCE ~HEET - ~ OF
E ~-~-~
A~O0
A~01
A210
*
Zr~tmsnt in IM~r~hele
$
~391
and Fecbr~l I~miv*blss
S~ Ind FedBr~l,
A~IO
Du~ f~ O'th~ 8overr..snts
TOTAL ~.~SETS
LZ~BZLTTZES ~ND FUND E~J~I'Y
FOR DOUBLE ENTRY L~ZTS ONLY )
£DPC~DE
A600 ~
Tot*l A~mx~d tisbilili~*
A(~I
A&~O
A&21
A630 *
A63!
$
$
AS~B
M82
·
$
J~x~primted-En~in~ Vemr's ~.~9~t A910
Umpprc1~'ced A911
Tohl Unreserved
TOTAL t3J~XLTTZES N~ F~B E~UXTY
GENERAL FUND
P~C~.IFrs/P~V~N~S
EDPCODE
PAYHENTS/EXPEND I~OP.E S
EDPCODE
Real Property Taxes AIO01
Charges for Fire Protection A2262
Interest end Ea~nings A2401
Rentals A2410
Sale of Equipment A2665
Insurance Recover/es A2680
Refund of Expend/Cures A2701
Gifts end Donations A2705
Other Unclaastfied Revenue
A2770
Federal Aid for Civil Defense A4305
Transfers A5031
(2)Budget Notes Issued A5750
(2)Tax Anticipation Notes Issued A5760
(2)Revenue Anticipation Notes
Issued A5770
TOTAL RECEIPTS/P~VEN-0ES
Judsments end Claims A1950.4
Personal Services A3410.1
Equipment/Capital 0utlay A3410.2
Fire Protection (Contractual) A3$10.$
State Retirement System A9010.8
Police and Fire Retire System A9015.8
Local Pension Funds A9025.8
Social Security A9030.8
Workers Compensation Insurance A90~0.8
Life Insurance
Disability Insurance A9055.8
Hedical/Accident Insurance A9060.8
(3) Redemption of Notes A97 __.6
Interest on Notes A97 __.7
Redemption of Bonds A9710.6
Interest on Bonds A9710.7
Transfer to Other Funds ~ A9901.9
Oth.r (Sp.ci y)
TOTAL PAY~ENI'S/~XPEND ITURET
Fund/Cash (1) Balance at Fund/Cash (1) Balance at /
Begirm~ng of Year A8021 /?.~.~.?/ End of
z?r.o
Year
(1) Cash balance for s~ugle entry units should ~nclude cash ~n checkin~ accounts, time deposits, investments end petty
cash.
(2) Single Entry Units Only.
(~) Only Bond Anticipation Notes and Capital Notes for double entry units.
*For Double Entry Units A8029 must equal Fund Equity on Page 1.
~These must be equal.
2
CAPZTAL PROJECI~ FUND - BAlaIHCE SHEET - AS OF
Toh*l
l~v~sbsnt in S.c~rlties
Due ~rae O~her Ftmcls
St~t~ and Fed~r~l, I~ceivab]~
C~h ~n Tfu.~ I~qx~it~, ~p~ci=l ~rve
lnv~bwnt in S~uriti~,
2nv~t.ant in Rapurd~.e
Sp~cisl ~
EOPCOOE
H~OO
fl~01
~91
H$~
~10
H~O
H~3!
$
$
$
LZ~XLXTXES MID FUHD E~JXTY
Aoafu~d
To4mX dkmrumd Li.bilili#
Du~ ~o O~her
Other Liabilities
To'c~l Li~billties
F~Icl B~lmrl~ -
Eirv:tldor'm',~
Cspit~l Ib~rve
To~&l ~
FLffld Bml,ln~ -
Urmp~r~pri~,t~d
To~:ml Unr~rv~d
F~cl Equi~'y
TOTAL J~ETS
TOTAL LXJ~BXLXTXES ~ID FUHO E~UXTY
(FOR DOUBLE ENTltY UNXTS ONLY)
H601 ~
H
S
H6~'&
$
H605
H630
H631
H
H69X
P,~7~
$
H911
$
CAPITAL FUND
RECEIPTS/EEVENUES EDPCODE
Interest and E&rn~ngs H2401 $
Prem. and Accrued Int. on Bonds H2710
Other (Specify)
H2770
Transfer From ~eneral Fund H$031
Bonds H$710
(1)Bond Anticipation Notes H5730
Capital Notes H5740
TOTAL RECEIPTS/EEVEKOES $
Fund/Cash Balance at Beg~--in~
of Year HS021
~IDTAL ~
pAYmENTS/EXPEND ITURES
Fire Protection
Redemption of BANts
Transfer to Other Fund
Other (Specify)
TOTAL PAYNENTS/EXPENDITURES
Fund/Cash Balance at End
of Year
EDPCODE
H3410.2
H9730.6
H9901.9
H
*H8029
(1) Si.ngle Entry Units Only
*For Double Entry Units H8029 must equal Fund Equity on Page 3.
**These must be equal.
RESERVE
FUND(S)
( F(~ ~ ENTRY UI~ QHLY,
0QUBLE ENI]~ UNZTS HUST ZNCLUDE
EACH ~ESERVE ZH ApIlROPP-ZA~ ~)
DoNor Key
I~CEZPTS
O~,~r (Sl~K::ify)
TOTAL RECE/PTS
Be)Jrme BeO~m~.r~ of Y~r
mrlOTAL RECEZPTS J~D BAL~ICE
pAYHENTS
FLr~ proration
Transfers ~o O~mr F~rgls
other iSp~ify)
TOTAL pAY~NTS
Be)mine m* End of Yeer
m~OTAL pAYHENTS MB BALN4CE
EDPCO~
R~01
R~'6&O
RE770
R,T~lO.2
R~1.9
To'h~l
TWIn (Purpose)
of Reserve
Typ~
of P~se~ve
$
$
$
TW)e
$
must b~ ~qu~l.
AGENCY I:iR, BS # BALANCE SHEET ~ AS OF ·
EDPCOOE
Cash TA~:OO
T/ma Dapo=it$ TA~'01
To*t.,1
AGENCY FUND LZABZLZTZES
E r,~qT~GE
TA~I TAS~
TOTAL ~ $ TOTAL ~ LZABZLZTZES &
~Progrts Ebinistr~tor rehin~d by distrio*. It~dn prc~ra, is idsinistr~ted by h district h TE ft~d .hou~d be used. S4~ S~rvi~e
Aoo~m~ing proDIll prcmedures d~d September &~ 1990.
6
(FOR D~I~-m-~E ENTRY UHXTS ONLY )
~ENERAL FZ)~D ,~ET~ AC'~_~T~ e BAIJHCE SHEET" ~S OF
EDPCOOE
K101
KXO~
KXO$
KX04
K105
EDI~ODE
~ ZH GENERAL FXXED _A~TS
Bmlch ~nd Notes KI.IG1
(:urrent ~proprlstlons K15~
Stlt~ Aid K1.6~
F~cbr~! Aid K~7
K
K
TOTAL X~NT XN ~ENERAL FXX~D ASSETS
6ENERAL LIBg-TEIU4 GSLZEtTIGNS # B~Ld~EE SHEET # AS OF , -- (FOIt DOUBLE ENTRY LI4ITS GNLY~
b *o ~ploy~s' ~tir~snt $~tm ~637
/nsbllmmt P~-~.~e Debt M68S
Judpm.nts ~nd clubs P~tbb .686
Other Leflg-Torm Debt H689
TOFAL AHIXJNT AV&ZLA~LE ~ TO BE PtIOVZDED
TOTAL L/A~/Lrl/ES
8
To*t:~l - All Fu, v:b ,.. · ...................................
Cash o~ Hefld IDeto D~osiied) .....
F~nd
1'NVE~ HELD AT DECEIVER $1~ 19 --
To~t~l Benk BoM, Cod1 on Hand, Potty Cosh end ~bmmts
9
DETAILED STATE~R~ OF INDEBTEDNESS
Bonds
(Sho~ each issue separately by)
EDP
Code
of Interest
Issue Rate
TOTAL BONDS 2P1877 Y~ XXX
Outstanding Issued Redeemed Outstanding
Begt-nin~ During During End
of Year Year Year of Year
1 3 5 7
TOTAL BONDS OUTSTANDING AS OF DECENBER 31 $
Notes
Tax Anticipation Notes 2P1861 ~ XXX ~ ~ ~ ~
Revenue Anticipation Notes 2P1862 ~ XXX
Budget Notes 2P1863 ~ XXX
Capital Notes 2P1875 Y~ XXX
Bond Anticipation Notes 2P1876 ~ XXX
TOTAL NOTES OUTSTANDING AS OF DECEMBER 31 $
TOTAL BONDS AND NOTES
10
EDP
Code
Assessed Valuation
of Fire District
Within To~n
Tax Rate
per $1,000
Assessed Valuation
Amount of Tax
(Assessed Valuation
Nultiplied by Tax Rate)
DISTRICT TOTAL
*Should aEree with Receipt of Real Property Taxes as sho~n at top of page 1
CONPUTATION OF FULL VALUATION OF TAXABLE REAL PROPERTY
Assessed Valuation
of Fire District
With/nTo~n
Equalization
Rate
Full Valuation
(Assessed Valuation
Dividedby
Equalization Rate)
Total Assessed
Valuation
Total Full Valuation
EDP
Code
9ZFE
BXAI~PLE OF CALCULATION OF FULL VALUATION:
Tc~n B
To.nC
Assessed Valuation
Full Valuation
$10,000
S,O00
20~000
935,000
11
25%
40~
100%
~40,000
12,500
20~000
~72~500
NOTXCES OF TIOIIT CLAXHS
EDP CO~E 14MBER
IuYAL AHOLIIT OF CLJL]]IS
TOTAL AIIOIJNT PAZD OH
EDP C(]OE MOLIIT EOF COOE MIOIMT
Claims Pending - B~linning of Y~r
'~ Im, olvinO Code~enden~/Third ~r~
O~r C~
~i~ Fi~ ~ ~ Y~r
~r C~im
Cbim di~ o~ ~ b ~r
Prior to
- ~ L~li~ ~0
- ~ ~ ~rrier
- C~ di~ of ~ ~ ~r
ef~ ~t of
- ~ ~ ~rr~ ~60
- O~r ( )
9ZTl116
9ZTRZ1 3
9ZTR26 4
9ZTR32
9Z'I114Z
9Zl'RSI 9ZTRSS' 7
9Z1~61 9ZTR6S~ 8
9Z'rR71 9Z1'RT~' 9
9ZTRSI 9Zl'R82 lO
Equals:
claim P~mding - End of Yo~r
~volvlnO Codofendmt/1~ird Party Defender
9ZTRgO 9ZTR91
X1
O~her CXeims 9ZTRg5 9Zl'R96
12
Article ~, Section SO-f of ~ho 8er4ral
Mi~in six~ ~ afbr b c~ of b fz~l ~r of ~ ~zo~l ~tz~ ~ ot ~ m~x~ or ~zisz~. A ~XO~A ~Z~, i
~ri~ ~ ~issim ~i~ ~ ~tim ~r~ of b ~ ~io~ b ~ fib m
~t~br ~ fib b ~t ~i~ ~ ~is ~ti~ Mi~ ~ f~b~ ~t.'
Tort ChSm fi~ or di~ of, p~ sb*o '~" ~ ~ ~is ~ ,i~ b ~
12
~ crams
ED~CODE
($)
AHO~I4T P~D ~A~R ~ EilUZTABLE SHAJ~
7 9Z'rR.64 9ZTR.q6 9z'rP_q8
8 ~fTl~6q 9ZTRO& 9ZTR&8
9 9ZTRTq 9ZTR70 9ZTR78
'10 9Z'TRSq 9ZTR86 9E1~88
Report prepered By:
Acldr~$
13
CERTIFICATE OF FIRE DISTRICT TREASUP, ER
(Please Pr/hr or Type Name)
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, /~/ .
Telephone (~f]~
Area
CHAIRHAN OF THE BOARD
Address
Telephone (
Area
Code
STATE OF NEW YORK
OFFICE OF THE STATE COHF'I'ROT.T~R
14
AL?. K01~BERS IN THIS ~ORT I~US~T BE ROUNDED TO THE NEA~_~ DOLIA_~R
ANNUAL RE?ORT ON
REV1/NUE$ AND EXPENDITURES OF FOREIGN FIRE INSURANCE PRE~IUHS
(NAHE AND T~PE OF ENTITY)
NA~E OF'~O~RN OR CITY ~wrIERE LOCATED N WHERE I~)CATED
N~ OF DISTRI~I' D (IF APPROPRIATE)
For the Fiscal Year Znaed /;/3//~ 7
/
(Date)
Balance:
Revenues:
(Date - Be&. of Year)
Fore/4~n Fire Ins.
Other Revenues
Total Revenues
Total Balance and Revenues
Expenditures:
EDPCODE
i&P8021 ...............
16P8022 ............
AHOUNT
Total Expenditures
16P8024 ............... ~.
Balance:
16P8029 ............... ~. ~
(SIGNATURE)
(T~T~g)
(SEE INSTRUCTIONS ON REVERSE SIDE)
accurate state~ent of the r~venu, es iud expenditures of foreign fire insurance
for the year ended /~/~//~/
_
prmiues
(Date)
v (~ss)
Please eail re~tt to:
Attention: Jeffrey ~adeJ, Associate Ex.inet
Office of the State C~troller
Division of ~icipal
State Office Build~
Alb~y, ~ 12236
FILIN~ INSTRUCTIONS:
1. All numbers in this report must be rounded to the nearest dollar.
The "beginning" balance 16P8021 should agree with last year's
"endin~" balance.
Any interest earned by investment (placing in savings accounts,
certificates of deposit, etc.) of the foreign fire insurance tax
moneys should be included in receipts.
Purposes of disbursements should be clearly stated in general
te~ms (recreational equipment; annual picnics; annual Christmas
party, etc.).
"Ending" balance 16P8029 should be the cash balance on hand as of
end of fiscal year.