HomeMy WebLinkAbout2003-193 VENT of rhE. �7
United States Department of the Interior _
_ FISH AND WILDLIFE SERVICE
H s 1875 Century Boulevard
Atlanta, Georgia 30345
In Reply Refer to: July 2003
FWS/R4/ARW/U
FY 2002
REFUGE REVENUE SHARING PAYMENT FORM
(October 1 , 2001 - September 30, 2002)
(PART 1 ) :
COUNTY COMPLIANCE CERTIFICATION
(With Section VI of the Civil Rights Act of 1964
Pertaining to Refuge Revenue Sharing Payments)
The undersigned assures that T N n T n N u T vER COUNTY/f ARM will administer payments
under the Refuge Revenue Sharing Act ( 16 U.S.C . 715s) in accordance with Section VI of the Civil Rights Act of 1964
(78 Stat. 252% 42 U. S.C . 2000d) and in compliance with the regulations issued pursuant thereto, which are contained in
rFar, 17 (se ; or search Internet for Code of Federal Regulations 43 CFR Part 17 revised 101112002).
� Chairman AlgtiGt• 12 , � n03
CO NTY/PpW RIEPRESENTATIVE TITLE DATE
Kenneth R . Macht
(PART 2) :
RECEIPT FOR CHECK
This annual payment is made in accordance with the Refuge Revenue Sharing Act
(amended in 1978 by Public Law 95469)
COUNTY/PABd&i Of INDIAN R VER _STATE Of FLORIDA
The check represents the GREATER of: three-fourths of 1 percent (0. 75 percent) of the fair market (appraised) value
of fee land acquired, or 25 percent of net receipts, or 75 cents per acre for fee lands located within the National Wildlife
Refuge System in the same County/Parish.
REC D BY **
Chairman August 12 ,
2003
COUNTY/PI REPRESENTATIVE TITLE DATE
Kenneth R . Macht 3151 52049000 $ 80 , 982 . 00
CHECK NO. CHECK AMOUNT
(Please return this signed form to Charlotte Underwood (404/679- 7216) in the self-addressed envelope attached)
1
15-51 M
000
Check No .
VV06 24 03 10 SAN FRANCISC04r CA 3151 52049000
M206030624 596000674
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M2 FWS
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USFWS REALTY
1875 CENTURY BLVD
ATLANTA GA 30345
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