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2005 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 November 30, 2004 PLEASE RETURN YELLOW COpy WITH PAYMENT Ysidoro & Rogene Moreno 1608 N. Fifth Street Salina, KS 081-01-0-20-01-002 1608 N. Fifth II'.".".".".".".".".".".".".".".".".".1..".".".".".".".".".".".".".".".".".It.. STATEMENT FOR 2005 RURAL FIRE CONTRACT January 1, 2005 through December 31, 2005 Cateaory Dm!! Percent ~ Mill Levy Amount Buildings Residential 11.5% X $80,200.00 X 0.018456 = $170.22 Land Residential 11.5% X $25,800.00 X 0.018456 = $54.76 Land Residential 30.0% X $2,450.00 X 0.018456 = $13.57 Amount Due: $238.54 Please make check payable to City of Salina and remit to prior to December 31. City of Saiina Attn: City Clerk's Office P.O. Box 736 Salina, KS 67402-0736 @ -------------------------------------- FOR OFFICIAL USE ONLY Amount Paid: /2./)6 /;ll_ Receipt No.: \~S _ l Received By: ~'. j\ I ',\ C e:) Date Received:~ -~-[-t,,:o~,s- " ~ ~,,; Salina 1 E: ,.,/()c~ ,/2()(J'-f- City of SaHna P.O. Box 736 Salina, Kansas 67402-0736 RECEIPT NO. -:1 ::: (~Lt.:3 DESCRIPTION 10-;'(:, AMOUNT F'I ::; ROTE F'ID 081-i)1-~:)-2{)-()1-()()2 10("-020 468. ooe 1608 r\j. F' I FTH ;~38 11 ::=::4 RE&~AfJ5!< 2:':373 FROM: 23E3 .. ::;i;. FC)GEi,JE r10F.ENO ORIGINAL RECEIPT Hi T ;iL :::.{:; I D E.:38 . '':;~r