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DR-700218 <br /> Application for Revenue Sharing 2009 = 2010 State Fiscal Year R. 04/09 z / <br /> ( Chapter 218, Part II Florida Statutes ) v{ d` 0 g ' / 7 <br /> Application deadline is June 30, 2009 <br /> Mail completed original application to : <br /> Department of Revenue <br /> Revenue Accounting Subprocess <br /> P . O . Box 6609 <br /> Tallahassee, FL 32399-6609 <br /> ( 850 ) 487 - 1150 <br /> revenueaccounting@dor . state .fl . us <br /> Please TYPE or PRINT <br /> Name of County INDIAN RIVER <br /> OR <br /> Name of Municipality County <br /> Telephone Number ( 772 ) 226 - 1206 <br /> Fax Telephone Number ( 772 ) 770 - 5331 <br /> Mayor or Chairman of Governing Body Wesley S . Davis , Chairman of the Board of County Commissioners <br /> Chief Fiscal Officer Jeffrey K . Barton , Clerk of the Circuit Court <br /> E - mail Address ehalsey@clerk . indian - river . org <br /> Official Mailing Address 1801 27th Street , Bldg . A , Vero Beach , FL 32960 <br /> ❑ Check here if the address represents a change from the previous application . <br /> Federal Employer I . D . Number ( required for new participants only) . <br /> Please complete the questions below to determine your eligibility to participate in Revenue Sharing for this <br /> fiscal <br /> year . <br /> 1 . Have you submitted your financial statements for fiscal year ending 09/ 30 /07 to the Department of <br />Financial Services <br /> as required by s . 218 . 32, F . S . ? <br /> OYes O No <br /> 2 . Have you made provisions for annual postaudits of your financial accounts as provided by <br /> s . 11 .45 , F . S . ? <br /> OYes O No <br /> 03/ 11 /2009 09/ 30 /2008 <br /> ate o 77 eport Fiscal Year- En <br />