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					County Form 105 State Form 1332 (R23 /4-09) Approved by State Board of Accounts for Miscellaneous County, 2009

SETTLEMENT SHEET FOR
For Collection of State, County Revenue and Other Taxes for the Year
SECTION A JUNE SETTLEMENT NET TAX, PENALTY & INTEREST PROPERTY TAX REPLACEMENT CREDIT 0.00 0.00 0.00 0.00 HOMESTEAD CREDIT TOTAL

COUNTY, INDIANA
Payable In
SECTION B APPORTIONMENT TOTAL NET PROPERTY TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 LICENSE EXCISE TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL PROPERTY TAX AND EXCISE TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

1 Collections Certified by County Treasurer: 2 Property Tax 3 Less: Erroneous Tax, Penalties and Interest Refunded 4 Less: State's Share of 2008 and Prior Delinquent Tax and Penalties Collected 5 Net Property Tax For Apportionment 6 License Excise Tax For Apportionment 7 TOTAL FOR APPORTIONMENT - Total of Lines 5 and 6 SECTION A-1 CHARGES: Charges Shown on March Abstract: Current Property Taxes Late Assessment Penalty Statement Processing Charge Delinquent Taxes, Penalties and Interest DECEMBER SETTLEMENT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

Additional Charges and Assessments During Year: Current Tax (Including Tax for Prior Years, Other Than Delinquent Tax Recharged) General Property Tax Mobile Home Tax Late Assessment Penalty and Statement Processing Charge Late Assessment Interest Additional Penalty Added on Prior Year Second Installment Penalty on Current First Installment Delinquent 10% Penalty on Former Years' Tax Delinquent Added After May 10 Delinquent Tax, Penalties and Interest Recharged: Tax Penalties and Interest Delinquent Tax Judgments Collected TOTAL CHARGES - Total of Lines 3 to 20 CREDITS Unpaid at This Settlement (Including All Charges and Assessments During Year) Current Second Installment Current First Installment Additional Penalty on Prior Year Second Installment Delinquent Penalty Current First Installment 10% Penalty on Former Years' Tax Delinquent Added After May 10 Former Years' Delinquent Tax All Penalties and Interest Unpaid (Except Lines 26, 27 and 28) Total Unpaid at This Settlement - Total of Lines 24 to 30 Tax,Pen. and Int. Certified to Clerk of Circuit Court Certificates of Error Issued During Year TOTAL CREDITS - Total of Lines 31 to 33 TOTAL COLLECTED THIS YEAR - Line 21 minus Line 34 Property Tax at June Settlement - Line 2, Section A AMOUNT FOR APPORTIONMENT -- Line 35 minus Line 36 Deductions Before Apportionment: Erroneous Tax, Penalties and Interest Refunded State's Share of 2008 and Prior Delinquent Tax and Penalties Collected TOTAL (Lines 39 through 41) NET TOTAL PROPERTY TAX FOR APPORTIONMENT (Line 37 minus Line 42) License Excise Tax For Apportionment TOTAL NET AMOUNT FOR APPORTIONMENT -- Total of Lines 43 to 45 SECTION C DUE STATE ON ACCOUNT OF GROSS REMITTANCE Indiana State Fair Board Tax 0.00 State Forestry Fund Tax 0.00 Hospital Care for Indigent Fund 0.00 Medical Assistance to Wards Fund 0.00 Children with Special Health Care Needs 0.00 Infraction Judgment 0.00 Overweight Vehicle Fines 0.00 Special Death Benefit 0.00 Sales Disclosure Fee 0.00 Coroner's Continuing Education Fee 0.00 Adult Offender Interstate Compact Fee 0.00 Mortgage Recording Fee 0.00 Child Restraint Fine 0.00 Canine Research and Education Fund 0.00 Forest Restoration Fund 0.00 Sex/Violent Offender Registration Fee 0.00

AMOUNT LESS LEVY EXCESS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

NET REMITTANCE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 NET AMOUNT DUE STATE

0.00

0.00

1 State Fair Board 2 State Forestry Fund 3 Hospital Care for Indigent Fund 4 Medical Assistance to Wards Fund 5 Children with Special Health Care Needs XXXXX XXXXX 6 County General Fund 0.00 0.00 7 County Health Fund 8 County Cumulative Bridge Fund 9 County Reassessment Fund 10 County Family & Children's Fund 11 County Children Psychiatric Services Fund 0.00 0.00 0.00 0.00 12 0.00 XXXXX XXXXX 0.00 13 0.00 XXXXX XXXXX 0.00 14 0.00 XXXXX XXXXX 0.00 15 0.00 0.00 0.00 0.00 16 17 18 0.00 0.00 0.00 0.00 19 0.00 0.00 0.00 0.00 20 0.00 XXXXX XXXXX 0.00 21 0.00 XXXXX XXXXX 0.00 22 Township General Fund 0.00 XXXXX XXXXX 0.00 23 Township Civil Bond Fund 0.00 XXXXX XXXXX 0.00 24 Township Assistance Fund 0.00 XXXXX XXXXX 0.00 25 Township Fire Fighting Fund 26 Township Recreation Fund 0.00 0.00 0.00 0.00 27 0.00 XXXXX XXXXX 0.00 28 0.00 XXXXX XXXXX 0.00 29 0.00 0.00 0.00 0.00 30 31 32 0.00 XXXXX XXXXX 0.00 33 0.00 XXXXX XXXXX 0.00 34 School General Fund 0.00 XXXXX XXXXX 0.00 35 School Debt Service Fund 0.00 XXXXX XXXXX 0.00 36 School Capital Projects Fund 0.00 XXXXX XXXXX 0.00 37 School Transportation Fund 0.00 XXXXX XXXXX 0.00 38 Pre-School Special Education Fund 0.00 XXXXX XXXXX 0.00 39 School Bus Replacement Fund 0.00 XXXXX XXXXX 0.00 40 School Referendum Fund 0.00 XXXXX XXXXX 0.00 41 School Pension Debt Fund 0.00 0.00 0.00 0.00 42 0.00 0.00 0.00 0.00 43 0.00 0.00 0.00 0.00 44 Library General Fund 0.00 0.00 0.00 0.00 45 Library Debt Service Fund 0.00 0.00 0.00 0.00 46 Library Capital Projects Fund 47 0.00 0.00 0.00 0.00 48 0.00 0.00 0.00 0.00 49 0.00 0.00 0.00 0.00 50 Corporation General Fund 0.00 0.00 0.00 0.00 51 Corporation M.V. Highway (Street) Fund 0.00 0.00 0.00 0.00 52 Corporation Bond Fund 0.00 XXXXX XXXXX 0.00 53 Corporation Firemen's Pension Fund 0.00 54 Corporation Police Pension Fund 0.00 0.00 0.00 0.00 55 56 STATE OF INDIANA, 0 COUNTY, SS: 57 58 59 60 I, the undersigned Auditor of said County, hereby certify that the foregoing is a true and complete abstract of 61 the settlement made this day with the Treasurer of said County and the amount to be paid into the State 62 Treasury on account of taxes and other items in the sum of $0.00 63 64 65 In Testimony Whereof, I have hereunto set my hand this __________ day of ____________________,__________. 66 67 68 _____________________________________________________________________________________________________ 69 County Auditor 70 71 72 73 74 75 76 77 78 INSTRUCTIONS 79 This semiannual Settlement Sheet must be filed with the Auditor of State on or before June 30 and 80 December 31 and the following must accompany each Settlement Sheet: 81 82 83 84 85 June & Dec. One Copy of the County Treasurer's Certificate of Tax Collections, 49TC 86 One Copy of the Summary of Certificate of Refund of Taxes, Form No. 17TC (if applicable) 87 88 89 90 91 Dec.One Copy of the Summary of Register of Certificates of Error, Form No. 127CER 92 Solid Waste District Fund One Copy of the Summary of Certificate of Refund of Omitted Homestead Credits, Form No. 17HC 93 Fire Protection District Fund Two Copies of the Report of Settlement of State Property Tax Replacement and Homestead 94 TIF-All Districts Credits Received from the State, Form 105A 95 TIR Inside TIF-All Districts 96 TIR Outside TIF-All Districts 97 TOTALS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00


				
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posted:11/15/2009
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