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2004 Statement 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 Salina Thursday, November 13, 2003 PLEASE RETURN YELLOW COPY WITH PAYMENT William & Verna Beth Hamel 1124 W. Grand Salina, KS 67401-0000 081-11-0-20-01-001 1124 W. Grand . II _ .._.._.._ .._ "_1'_1'_1' _ '__1' _'1 _ "_1' _ II _. ._.._.._. 1_1'_1' _II _"_"_1'_' '_1' _.._. '_1' _'1__ '-1' _'1_1'- ..-..-. STATEMENT FOR 2004 RURAL FIRE CONTRACT January 1, 2004 through December 31, 2004 CateQorv I.mg Percent Value Mill Levv Amount Land Residential 11.5% X $37,560.00 X 0.017598 = $76.01 Buildings Residential 11.5% X $101,840.00 X 0.017598 = $206.10 Amount Due: $282.11 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 Paid: 2'82. II Receipt No.: t.ol(f:fr~ Received By: ~A )~. Y S Date Received: l\ en"' (fi~2. City of Salina P.O. Box 736 Salina, Kansas 67402-0736 RECEIPT NO. 65587 DESCRIPTION .... -) AMOUNT FIRE PROTE PID#081-11-0-20-01-001 100-000 468.000 1124 W GRAND 282.11 CHECK 8055 RECEIVED FROM: 282.11 Wt'1. ROGER HAMEL TOTAL PAID 282.11 ORIGiNAL RECEiPT '~',';