06-28-1995 Council Agenda - Laserfiche WebLink

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SECTION 7 - PENSION PAYMENTS (For Lump Sum and Defined Contribution Plans only) SECTION 8 CERTIFICATION BY SECRETARY AND TREASURER OF RELIEF ASSOCIATION, MUNICIPAL FIRE DEPARTMENT, OR INDEPENDENT NON - PROFIT FIREFIGHTING CORPORATION We 'fy/that to the best of our knowledge and belief, the facts presented in iGu NA TURF OF SEC EF ASSOCIATION .tM.r RELIEF ASSOCIATION OF MUNICIPAL CLERK (If Independent Non- Profit Firefighting Corpora- ... -- _ Municipal Clerk of the largest municipality in population contracting with the Independent Non -Profit Firefighting Corporation must sign) de-P •;IGNATURE OF SECRETARYOF MEP. FIREFIGHTING CORP. (if applicable) this report are true and accurate. 6Nic DATE/ p�- /'- -7—�- DD P i DATE DATE z1/9-/q73 BUSINESS PHONE BUSINESS PHONE WY - *ow 7 7 BUSINESS PHONE 4/W3-3C/7 ; BUSINESS PHONE Al I STATION REPORT OR AUDIT BY LICENSED OR CERTIFIED PUBLIC ACCOUNTANT Associations with assets and liabilities under $200,000, pursuant to Minn. Stat. § 69.051 subd. la(b), an independent public accountant shall examine the financial information included within the financial section of this reporting form. The independent public accountant shall attest to the financial information required by Minn. Stat. § 69.051 subd. la(a). the examination should be conducted in accordance with standards established by the American Institute of Certified Public Accountants and should include such procedures as prescribed by the Office of the State Auditor. The independent public accountant's attestation report must be submitted with this reporting form. Your deadline to submit all information to the State Auditor is March 31st. Associations with assets or liabilities equal to or greater than $200,000 must furnish audited financial statements prepared in accordance with generally accepted accounting principles (including foomote disclosures) together With an Auditor's Opinion and an Auditor's Report on Internal Control and Legal Compliance. The Auditor's opinions, and audited financial statements must be submitted with this reporting form to constitute a complete file. Your deadline to submit all information to the State Auditor is June 30th. NAME OF LICENSED /CERTIFIED PUBLIC ACCOUNTANT: STATE LICENSE NUMBER: ADDRESS OF LICENSEDICERTIF7ED PUBLIC ACCOUNTANT: PHONE NUMBER OF LICENSED /CERT. PUBLIC ACCOUNTANT: . mail this form (after signatures) to: Tautges, Redpath & Co., Ltd. 359 4810 White Bear Parkway, White Bear Lake, MN 55110 (612) 426 -7000 Office of the State Auditor - Pension Oversight 525 Park Street, Suite 400 Saint Paul, MN 55108 Page 90 NAME ENTRY DATE RETWEMENT DATE BENEFIT PAID SUPPLEMENTAL BENEFIT PAID TOTAL Dan Peterson 12/67 4/94 53,812 1,000 .54,812 Frank Graczyk 12/66 3/94 55,862 1,000 56,862 Troy Colvard 6/73 10/93 42.879 1 non 4't r.R711 Tom Stadler 5/72 6/93 45,023 1,000 4R n21 SECTION 8 CERTIFICATION BY SECRETARY AND TREASURER OF RELIEF ASSOCIATION, MUNICIPAL FIRE DEPARTMENT, OR INDEPENDENT NON - PROFIT FIREFIGHTING CORPORATION We 'fy/that to the best of our knowledge and belief, the facts presented in iGu NA TURF OF SEC EF ASSOCIATION .tM.r RELIEF ASSOCIATION OF MUNICIPAL CLERK (If Independent Non- Profit Firefighting Corpora- ... -- _ Municipal Clerk of the largest municipality in population contracting with the Independent Non -Profit Firefighting Corporation must sign) de-P •;IGNATURE OF SECRETARYOF MEP. FIREFIGHTING CORP. (if applicable) this report are true and accurate. 6Nic DATE/ p�- /'- -7—�- DD P i DATE DATE z1/9-/q73 BUSINESS PHONE BUSINESS PHONE WY - *ow 7 7 BUSINESS PHONE 4/W3-3C/7 ; BUSINESS PHONE Al I STATION REPORT OR AUDIT BY LICENSED OR CERTIFIED PUBLIC ACCOUNTANT Associations with assets and liabilities under $200,000, pursuant to Minn. Stat. § 69.051 subd. la(b), an independent public accountant shall examine the financial information included within the financial section of this reporting form. The independent public accountant shall attest to the financial information required by Minn. Stat. § 69.051 subd. la(a). the examination should be conducted in accordance with standards established by the American Institute of Certified Public Accountants and should include such procedures as prescribed by the Office of the State Auditor. The independent public accountant's attestation report must be submitted with this reporting form. Your deadline to submit all information to the State Auditor is March 31st. Associations with assets or liabilities equal to or greater than $200,000 must furnish audited financial statements prepared in accordance with generally accepted accounting principles (including foomote disclosures) together With an Auditor's Opinion and an Auditor's Report on Internal Control and Legal Compliance. The Auditor's opinions, and audited financial statements must be submitted with this reporting form to constitute a complete file. Your deadline to submit all information to the State Auditor is June 30th. NAME OF LICENSED /CERTIFIED PUBLIC ACCOUNTANT: STATE LICENSE NUMBER: ADDRESS OF LICENSEDICERTIF7ED PUBLIC ACCOUNTANT: PHONE NUMBER OF LICENSED /CERT. PUBLIC ACCOUNTANT: . mail this form (after signatures) to: Tautges, Redpath & Co., Ltd. 359 4810 White Bear Parkway, White Bear Lake, MN 55110 (612) 426 -7000 Office of the State Auditor - Pension Oversight 525 Park Street, Suite 400 Saint Paul, MN 55108 Page 90