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2002 (1728 S Marymount Rd) (2)City0f Salina Friday, October 18, 2002 Genie Ulrich Jerry D. Vanier Trust P.O. Box 1562 Salina, KS 67402-1562 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 Nicola, City Clerk Telephone (785) 309-5735' Fax (785) 309-5738 PLEASE RETURN YELLOW COPY WITH PAYMENT 094-19-0-40-02-012 1728 S. Marym uni Road STATEMENT FOR 2003 RURAL FIRE CONTRACT January 1, 2003 through December 31, 2003 Category Type Percent Value Mill Lew Amount Land Residential 30.0% X $900.00 X 0.01773 = $4.79 Land Residential 11.5% X $2,500.00 X 0.01773 = $5.10 Buildings Residential 11.5% X $264,160.00 X 0.01773 = $538.61 Amount Due: $548.49 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 2 Amount Paid: � /` � Receipt No.: `7 05 ' _ t — t� Received By: Date Received: