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DR-700218 R . 04/04 Page 2 3 . Levied , as shown on its most recent financial report , pursuant to s . 218 . 32 , F. S . , ad valorem taxes , exclusive of taxes levied for debt service or other special millages authorized by the voters , to produce the revenue equivalent to a millage rate of three (3 ) mills on the dollar based on the 1973 taxable values as certified by the property appraiser, pursuant to s . 193 . 122 (2) , F. S . , ® Yes No OR In order to produce revenue equivalent to that which would otherwise be produced by such a three (3) mill ad valorem tax : (A) to have received a remittance from the county pursuant to s . 125 . 01 (6) (a) , F. S . ; ( B) collected an occupational license tax ; (C) collected a utility tax ; ( D ) levied an ad valorem tax; ( E ) received revenue from any combination of these four sources ? Yes 0 No 4. Certified that: (A) Law enforcement officers , as defined in s . 943 . 10 ( 1 ) , F. S . , employed by this Unit meet the qualifications for employment as established by the Criminal Justice Standards and Training Commission ? 0 Yes No ( B ) The salary structure and salary plans for law enforcement officers meet the provisions of Chapter 943 , F. S . ? EE] Yes No ( C) All law enforcement officers , as defined in s . 943 . 1 0( l ) , F. S . , are compensated at an annual salary rate of six thousand dollars ($6 , 000) or more ? tj Yes a No [If the answer to (C) above is ( NO ) , please state in an addendum to this application any reason you may have for waiver of such requirement (one of which must be that you are levying ten ( 10) mills of ad valorem taxes ) .] Com„ /Signed : � Date : 'Sua ` �, ,�r Appripiriate Law Entprcement Officer [ If you have no police department , etc . , please check the block to the left side .]