HomeMy WebLinkAbout2009-143 DR-700218
Application for Revenue Sharing 2009 = 2010 State Fiscal Year R. 04/09 z /
( Chapter 218, Part II Florida Statutes ) v{ d` 0 g ' / 7
Application deadline is June 30, 2009
Mail completed original application to :
Department of Revenue
Revenue Accounting Subprocess
P . O . Box 6609
Tallahassee, FL 32399-6609
( 850 ) 487 - 1150
revenueaccounting@dor . state .fl . us
Please TYPE or PRINT
Name of County INDIAN RIVER
OR
Name of Municipality County
Telephone Number ( 772 ) 226 - 1206
Fax Telephone Number ( 772 ) 770 - 5331
Mayor or Chairman of Governing Body Wesley S . Davis , Chairman of the Board of County Commissioners
Chief Fiscal Officer Jeffrey K . Barton , Clerk of the Circuit Court
E - mail Address ehalsey@clerk . indian - river . org
Official Mailing Address 1801 27th Street , Bldg . A , Vero Beach , FL 32960
❑ Check here if the address represents a change from the previous application .
Federal Employer I . D . Number ( required for new participants only) .
Please complete the questions below to determine your eligibility to participate in Revenue Sharing for this
fiscal
year .
1 . Have you submitted your financial statements for fiscal year ending 09/ 30 /07 to the Department of
Financial Services
as required by s . 218 . 32, F . S . ?
OYes O No
2 . Have you made provisions for annual postaudits of your financial accounts as provided by
s . 11 .45 , F . S . ?
OYes O No
03/ 11 /2009 09/ 30 /2008
ate o 77 eport Fiscal Year- En
DR-700218
R. 04109
Page 2
3 . Have you reported on your most recent financial statement revenues equivalent to three mills calculated based
on
your 1973 taxable values ? This revenue should be net of debt service or special millages approved
by the voters .
The revenue can be generated by a combination of ad valorem tax, utility tax , occupational license tax,
or a payment
from the county as allowed by s . 125 .01 , Florida Statutes .
*Yes ONo
4 . If you have a law enforcement department, answer the questions below : ( If you have a contracted or
strictly
volunteer department, skip to question 5 )
( A ) Have your law enforcement officers, as defined by s . 943 . 10 ( 1 ) , F . S ., met the qualifications
for employment as
established by the Criminal Justice Standards and Training Commission , and do you compensate them at an
annual salary rate of six thousand dollars ( $ 6 , 000 ) or more ?
* Yes O No
( B ) Does the salary structure and salary plans for law enforcement officers meet the requirements of
Chapter 943 F . S . ?
* Yes O No
5 . If you have a fire department, answer the questions below : ( If you have a contracted or strictly volunteer
department, skip to question 6 )
( A ) Have your firefighters, as defined by s . 633 . 30 ( 1 ) , F . S ., met the requirements stated in s .
633 . 34, 633 . 35 , and
633 . 382 F . S .
* Yes O No
( B ) Does your fire department employ any full -time firefighters , who currently have either a bachelor' s degree
or
associate degree from a college or university which is applicable to fire department duties, if the degree
is not a
requirement for their current position ?
OYes O No
( C ) If so , are these firefighters currently receiving supplemental compensation for those degrees ?
*Yes O No
6 . Are dependent special districts budgeted separately from the general budget of your government ? Do they
meet the
provisions for annual postaudit of their financial accounts in as provided by s . 11 .45 ( 3 ) , F . S . ?
*Yes 0N 0Does Not Apply
7 . Have you met the requirements of s . 200 .065 , F . S ., if applicable ? (The annual certification must be
within 30 days of
adoption of an ordinance or resolution establishing a final property tax levy or, if no property tax is
levied , not later
than November 1 .
* Yes O No
The portion of revenue sharing funds which , according to Part ll , Chapter 218 , F . S ., would otherwise
be distributed
to a unit of local government which has not certified compliance or has otherwise failed to meet the requirements
of s . 200 . 065 , F . S ., shall be deposited in the General Revenue Fund for the 12 months following a
determination of
noncompliance by the department . )
DR-700218
R. 04/09
Page 3
1 certify that all information is accurate and true to the best of my knowledge . I further certify that I will
promptly
report to the Department of Revenue any changes in the above information . I also realize that failure to
provide timely
information required , allows the Department to utilize the best information available . If no such information is
available,
the Department will take necessary action including disqualification , either partial or entire, and you will waive your
right to challenge the determination of the Department to your share of funds , if any, beyond your minimum entitlement,
according to the privilege of receiving shared revenues from the Revenue Sharing Trust Funds .
Do you believe that you have complied with ALL eligibility requirements as listed above ?
OYes O No
If the answer to question above is ( NO ) , please provide an attachment of the revenue necessary to meet your
obligations
because of pledges or assignments or trusts entered into which obligated funds received from revenue sharing .
1� Date : 05/ 18/2009
Signed : _
Chief Fiscal Official — _--
Signed : ""e�- Date : June 2 , 2009
ayor or Chairman of Governing Body — — —
1,sley S . Davis , _ Halrman
(Mail completed original application to address shown below .
Florida Department of Revenue
Revenue Accounting Subprocess
PO Box 6609
Tallahassee FL 32399-6609
revenueaccounting@dor. state .fl . us