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2004 Statement . Salina Department of Finance and Administration Office of City Clerk 300 West Ash Street, Suite 206 * P.O. Box 736 Salina, KS 67402-0736 Rodney Franz, Finance Director * Lieu Ann Elsey, City Clerk Telephone (785) 309-5735 * Fax (785) 309-5738 " Thursday, November 13, 2003 PLEASE RETURN YELLOW COPY WITH PAYMENT Raymond Freeman Babette S. Freeman Trust #1 1901 E. Iron Salina, KS 67401-0000 093-07-0-40-01-014 1901 E. Iron ....1..".".' ..............1.."."." ........1." .......1.....1..1.." .......... ........... ."."."."."_'1.' STATEMENT FOR 2004 RURAL FIRE CONTRACT January 1, 2004 through December 31, 2004 Cateaorv ~ Percent Value Mill Levv Amount Land Residential 11.5% X $21,760.00 X 0.017598 = $44.04 Buildings Residential 11.5% X $164,700.00 X 0.017598 = $333.31 Amount Due: $377.35 Please make check payable to City of Salina and remit to prior to December 31. City of Salina Attn: City Clerk's Office P.O. Box 736 Salina, KS 67402-0736 -------------------------------------- FOR OFFICIAL USE ONLY Amount pai~"'Srr1~?75 Receipt No.: lJ)C()'l.~ Received BY:J ~ ) CO Date Received:Q.11r 2m3 ~ ~ ~ . . . City of Salina P.o. Box 736 Salina, Kansas 67402~0736 RECEIPT NO. 6:;:; (j ;~.~;~ 1""'\.-. i :.) DESCRIPTION AMOUNT FIRE PROTE PID# 093-07-0-40-010-014 1 (H)--OOO 46E:. 000 1901 E:. I F\:ON :377" 35 CHEC!< 9219 RECEIVED FROM: 37'7 _ 3t:; RAYMOND S. FREEMAN C:P~Gi:',~/.L REC[~.':'T TOT AI.... FA I D :37'7" :::5