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Official Document Type
Agenda Item Number
Department of Revenue
Application Revenue Sharing 2004-2005 State Fiscal Year
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7 � <br /> Application For Revenue Sharing 2004-2005 State Fiscal Year DR-700218 R . 04/04 <br /> (Chapter 218 , Part II Florida Statutes) a L, / <br /> 7 <br /> DEPARTMENT <br /> OF REVENUE Application must be received by the Department of Revenue prior to June 30, 2004 <br /> Please TYPE or PRINT all entries except those requiring a signature . <br /> Part One <br /> Name of County Indian River <br /> OR <br /> Name of Municipality County <br /> Telephone Number ( 772 ) 567 - 8000 <br /> Fax Telephone Number ( 772 ) 770 - 5331 <br /> Mayor or Chairman of Governing Body Caroline D . Ginn <br /> Chief Fiscal Officer Jeffrey K . Barton <br /> Official Mailing Address 1840 25th Street <br /> Vero Beach , FL 32960 - 3365 <br /> F Check here if the address represents a change from the previous application . <br /> Federal Employer I . D . Number ( required for new participants only) . <br /> Part Two <br /> To be eligible to participate in Revenue Sharing beyond the minimum entitlement as defined in s . 218 . 21 (7 ) , F. S . , for <br /> any <br /> fiscal year, a unit of local government is required to have fulfilled certain requirements set forth in s . 218 . 23 , F. S <br />. , including <br /> certification requirements . Signatures by the appropriate official in the signature blocks , where applicable , shall constitute <br /> fulfillment of the certification requirements set forth in s . 218 .23 , F. S . <br /> Consistent with the requirements of s . 218 . 23 , F. S . , has the applicant: <br /> Note: Question 1 and 2 pertain to financial audit requirements . If a financial audit was required, report <br /> on the most recently completed audit period . Fiscal year ending 09/30/02 will be sufficient for this <br /> purpose . <br /> 1 . Reported its finances for its most recently completed fiscal year to the Department of Banking and Finance , <br /> pursuant to s . 218 . 32 , F. S . ? <br /> Yes No <br /> 2 . Made provisions for annual postaudits of its financial accounts in accordance with s . 11 .45 , F. S . ? <br /> Yes No January 30 , 2004 <br /> Date of Audit Report <br />
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