Affidavit and Revenue Certification. Ward One Economic Development Board ENTITY NAME Calcasieu Parish Lake Charles. Louisiana (City), State

Transcription

1 Affidavit and Revenue Certification Ward One Economic Development Board ENTITY NAME Calcasieu Parish Lake Charles. Louisiana (City), State ANNUAL SWORN FINANCIAL STATEMENTS AND CERTIFICATION OF REVENUES $75,000 OR LESS (if applicable) The annual sworn financial statements are required by Louisiana Revised Statute 24:514 to be filed with the Legislative Auditor within 90 days after the close of the fiscal year. The certification of revenues $75,000 or less, if applicable, is required by Louisiana Revised Statute 24:513(J)(1)(c)(i)(aa). ****************************** **** ***********************************************************< Personally came and appeared before the undersigned authority, Michelle Mclnnis (officer name), who, duly sworn, deposes and says that the financial statements herewith given present fairly the financial position of Ward One Economic Development Board (entity name) as of December (entity's year-end), and the results of operations for the year then ended, in accordance with the basis of accounting described within the accompanying financial statements. (Complete if applicable) In addition, Michelle Mclnnis. (officer name), who, duly sworn, deposes and says that Ward One Economic Development Board (entity name) received $75,000 or less in revenues and other sources for the year ended December and accordingly, is not required to have an audit for the previously mentioned year. Officer Signature Swom to and subscribed before me this day of. 20IL. f^4a f NOTARY PUBLIC ' *** ************ ******************************************* ** ********#************************* Officer's Name Michelle Mclnnis Officer's Title Board President Address PO Box Lake Charles. LA c an^ nf stale law this report is E Under report has been submitt^5h?fax/ mmacinthebluff@qmail.com the'^ntfty and other appropriate reoort is available for public inspection at the Bato R^ae office of the Legislative Auditor and where appropriate, at the offk» of the parish clerk of court. Release Pnf" ^ ^ Please return the completed form within 90 days of your entity's vear-end to Office of Legislative Auditor- Local Government Services. Post Office Box Baton Rouae. LA

2 TRANSMITTAL LETTER Ward One Economic Development Board (Entity Name) Lake Charles. Calcasieu City. Parish, ^CCEIVFO ' AUFirop MIEH/.R-7 AHSrl7 ANNUAL FINANCIAL STATEMENTS (Date). Ms. Suzanne Elliott Engagement Manager Office of Legislative Auditor 1600 North Third Street Baton Rouge, LA Dear Ms. Elliott: In accordance with Louisiana Revised Statute 24:513, enclosed are the Affidavit and Revenue Certification Form and the annual financial statements for my entity, as of and for the year ended December The statements Include all funds under the control of this entity. The accompanying financial statements have been prepared on the cash basis of accounting. Sincerely, Enclosures Officer's Signature Michelle Mclnnis Officer's Name PLEASE RETAIN A COPY OF THE COMPLETED FINANCIAL STATEMENT FOR YOUR RECORDS Please return the completed form within 90 days of your entity's vear-end to Office of Legislative Auditor Local Government Services. Post Office Box Baton Rouge. LA

3 Statement A Ward One Economic Development Board (Agency Name) Statement of Cash Receipts and Disbursements For the Year Ended December 31, 2015 (Year-End) General Other Total RECEIPTS (Provide Brief Description): 1. Interest Earned $8.51 $0 $ Parade Entry Sponsor ^ $ $ Total receipts (add lines 1-5) $ $ DISBURSEMENTS (Provide Brief Description): 7. Chamber of Commerce Membership Dues $ $ PO Box Yearly Fees $ Bereavement (flowers) Parade Insurance Total Disbursements (add lines 7-12) $ $ 0 $ Change in fund balance (Lines 6 minus 13) $ (509.94) $0 $ (509.94) 15. Balance at beginning of year $ $ 0 $ balance (deficit) at end of year (Add lines 14-15) -This amount also goes on line 12, Statement B $ $0 $ PLEASE RETAIN A COPY OF THE COMPLETED FINANCIAL STATEMENTS FOR YOUR RECORDS Please return the completed form within 90 days of vour entity's vear-end to Office of Legislative auditor - Local Government Services. Post Office Box Baton Rouae. LA

4 Statement B Ward One Economic Development Board (Agency Name) Balance Sheet, on December (Year-End) General Other Total ASSETS (balances at year-end) -Give brief description: $ $0 $ Investments (fair value) on hand Office furnishings (Cost of desks, etc) Equipment (Cost of fax machine, etc) Other (brief description) Total Assets (add lines 1-5) $ $0 $ LIABILITIES AND FUND BALANCE (at year-end): 7. Liabilities (give brief description): 8. $0 $0 $ Total Liabilities (add lines 7-10) balance (amount from Line 16 on Statement A) $ Other Total Liabilities and Balance (add lines 11-13) $ $0 $ PLEASE RETAIN A COPY OF THE COMPLETED FINANCIAL STATEMENTS FOR YOUR RECORDS Please return the completed form within 90 davs of vour entity's year-end to Office of Legislative auditor - Local Government Services. Post Office Box Baton Rouge. LA

5 Statement C Ward One Economic Development Board (Agency Name) Schedule of Compensation, Benefits and Other Payments to Agency Head or Chief Executive Officer (REQUIRED, PLEASE SUBMIT COMPLETED FORM, PER ATTACHED INSTRUCTIONS) Agency Head Name/Title: Michelle Mclnnis. President Purpose Amount Salary 0 Benefits-insurance 0 Benefits-retirement 0 Car allowance 0 Vehicle provided by government 0 (enter amount reported on W-2) Per diem 0 Reimbursements 0 Travel 0 Registration fees 0 Conference travel 0 Housing 0 Unvouchered expenses (example: 0 travel advances, etc.) Special meals 0 Other 0