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Rei DR-700218 <br /> Application for Revenue Sharing 2011 =2012 State Fiscal Year R. 01 /11 <br /> ( Chapter 218 , Part II Florida Statutes ), <br /> �(: �,.tiKThiFvT <br /> or REVENUE <br /> Application deadline is June 30 , 2011 C <br /> Mail completed original application to : <br /> Department of Revenue <br /> Revenue Accounting Subprocess <br /> P . O. Box 6609 <br /> Tallahassee , FL 32314-6609 <br /> 850 -617 -8586 <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 Bob Solari , 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 fiscal <br /> year. <br /> 1 . Have you submitted your financial statements for fiscal year ending 09/30/09 to the Department of Financial Services <br /> as required by s . 218 . 32 , F . S . ? <br /> a Yes No <br /> 2 . Have you made provisions for annual postaudits of your financial accounts as provided by <br /> s . 11 . 45 , F . S . ? <br /> ❑X Yes F-1 No <br /> 03/ 11 /2011 09/30/2010 <br /> Date of Audit Report Fiscal Year-End <br />