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2004 ...,J 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 James Leiker 1797 E. Magnolia Salina, KS 67401-0000 099-30-0-40-01-002 1797 E. Magnolia STATEMENT FOR 2004 RURAL FIRE CONTRACT January 1, 2004 through December 31, 2004 CateQorv IYlli! Percent Value Mill Levv Amount Land Residential 11.5% X $23,000.00 X 0.017598 = $46.55 Buildings Residential 11.5% X $191,900.00 X 0.017598 = $388.36 Amount Due: $434.91 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: ~ Receipt No.: lD:::4()~ Received By: ~6 Date Received: IStfe.2ctaJ City of Salina P.O. Box 736 Salina, Kansas 67402-0736 c::: ~ RECEIPT NO. ,::'50::1-03 'I c) DESCRIPTION AMOUNT FIRE ~ROTE PID# 099-30-0-40-01-002 100-000 468.000 1797 E MAGNOL 1;'\ i~.3lt. . 91 CHECK 321 c;, RECEIVED FROM: 43'+ .. 91 J'AI'1ES S. LE I KER TOTAI_ F'A 1 D ':+34 . S'l OmG1NAl RECEIPT