Affidavit and Revenue Certification. D.lSA^'J TJidM^o^^/n,:bs^ /^6lU0^AiJl-tAtisl tf/y^^/^k/ ENTITY NAME. ^iilj/frj Parish

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1 ^AV Affidavit and Revenue Certification D.lSA^'J TJidM^o^^/n,:bs^ /^6lU0^AiJl-tAtisl tf/y^^/^k/ ENTITY NAME ^iilj/frj Parish J}/^i/!/JjLy L/J (City). State ANNUAL SWORN FINANCIAL STATEIVIENTS AND CERTIFICATION OF REVENUES $50,000 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 $50,000 or less, if applicable, is required by Louisiana Revised Statute 24:513(l)(1)(c)(i). ************************************************************************************************* Personally came and appeared before the undersigned authority, AJ^ ^AVicl ^Jicm/OS0^ (officer name), who, duly sworn. d^pqses and savsthalthe financial statements herewithdiven present fairly the financial position of ^'^^V/^r^^^ (entity name) as of 'q)stxj9.^vn tuu <3 L J/0/3 (entity's year-end)' and tfte'results of operations for the year then ended, in accordance with the basis of accounting described within the accompanying financial statements. (Complete if applicable), i ^ i In ac(ditioa _/J * PAt/^o} J^j^^^sj. (officer name), who, duly sworn, deposes and says that ^'^/S^y^ ji7cn ^a^e) received $50,000 or less In revenues and other sourcestot tne year enaea V?<^e^^t^ ^l 2c/3. and accordingly, is not required to have an audit for the previously mentioned year. ' OfficerSignature ^ Sworn to and subscribed before me this \CT" day of VsAfUcW 20 IT., w V, ' r\ V ' MEUSSA C. KING ^^- ^>SAJLA^^ V^.\\yjrsi\ NOTARY PUBILC NOTARY PUBU^ 1D# **************************************************************************************************** ' : " Officer's Name A^- ^/hvfo ^/A^mASQ/^ Under provisions of state law, this report is a pjdtfficer's Title CL ^fi^^^^'^a^ document Acopy of the report has been submitt^^ggg /i?/z /y^yisj^ ^ra^t/t the entity and other appropriate public officials^ Tfie MA^tfl//^. /^^ Y/^Z^ report IS available for public inspection at the B JPa,^^ j, 2V/^1 7iVJ^V^ \ L ^ ^ Rouge office of the Legislative Auditor and. wfrflr a^/t man SJ^r? /^<r ^OH^ />6q^^ appropriate, attheofficeofthe parish clerk of court. CVS) 73LS' 9B7I -^/fx ^ _ ^ ^ APR H Release Date "' Please return the completed form within 90 days of vour entity's year-end to Office of Legislative Auditor Local Government Services. Post Office Box Baton Rouge. LA

2 W. DAVID THOMPSON, M.D., CORONER-PAWSH OF RICHLAND FINANCIAL STATEMENTS For The Year Ended December 31,2013 -ooooo- OSWALT & ZARRO - CEfHIFIED PUBUC ACCOUffTANTS

3 OSWALT & ZARRO A Corporation of Certified Public Accountants 809 Julia Street Suite A Rayville, LA (318) (318) (Fax) To Management W. David Thompson, M.D., Coroner-Parish of Richland Rayville, Louisiana Tom J. Oswalt, CPA Joseph J, Zarro, CPA ACCOUNTANTS' COMPILATION REPORT 204 Fair Avenue Suite B Winnsboro, LA (318) (318) (Fax) We have compiled the accompanying statement of assets, liabiuties, and proprietor's capital-income tax basis of W. David Thompson, M.D., Coroner-Parish of Richland (a proprietorship) as of December 31, 2013, and the related statements of revenues and expenses-income tax basis and changes in proprietor's capital-income tax basis for the year then ended. We have not audited or reviewed the accompanying fmancial statements and, accordingly, do not express an opinion or provide any assurance about whether thefinancialstatements are in accordance with the income tax basis of accounting. Management is responsible for the preparation and fair presentation of thefinancialstatements in accordance with the income tax basis of accounting and for designing, implementing, and maintaining intemal control relevant to the preparation and fair presentation of the financial statements. Our responsibility is to conduct the compilation in accordance with Statements on Standards for Accounting and Review Services issued by the American Institute of Certified Public Accountants. The objective of a compilation is to assist management in presentingfinancialinformation in the form offinancialstatements without undertaking to obtain or provide any assurance that there are no material modifications that should be made to thefinancialstatements. Management has elected to omit substantially all of the disclosures ordinarily included in financial statements prepared in accordance with the income tax basis of accounting. If the omitted disclosures were included in thefinancialstatements, they might influence the user's conclusions about the Company's assets, liabilities, capital, revenues, and expenses. Accordingly, the financial statements are not designed for those who are not informed about such matters. The accompanying financial statements do not include a provision or liability for federal income taxes because the proprietor is taxed individually on the company's eamings. We are not independent with respect to W. David Thompson, M.D., Coroner-Parish of Richland. March 4,2014

4 W. DAVID THOMPSON, M.D., CORONER-PARISH OF RICHLAND STATEMENT OF ASSETS, UABIUTIES, AND PROPRIETOR'S CAPITAL-INCOME TAX BASIS December 31, 2013 ASSETS CURRENT ASSETS CASH-GUARANTY BANK 5, , TOTAL ASSETS LIABILITIES AND PROPRIETOR'S CAPITAL CURRENT LIABILITIES PAYROLL TAXES PAYABLE TOTAL LIABILITIES PROPRIETOR'S CAPITAL 4, , TOTAL LIABILITIES AND PROPRIETOR'S CAPITAL 5, See accountants' compilation report. OSWALT & ZARRO CERTIFIED PUBUC ACCOUNTANTS

5 W. DAVID THOMPSON, M.D., CORONER-PARISH OF RICHLAND STATEMENT OF REVENUES AND EXPENSES- INCOME TAX BASIS For the Year Ended December 31,2013 REVENUES CORONER FEES $ OPERATING EXPENSES ADVERTISING & PROMOTION CONTINUING EDUCATION CONTRACT LABOR-DEPUTY CORONER 3, LEGAL FEES OFFICE EXPENSE PAYROLL TAXES SALARIES-OTHER 3, TAXES & LICENSES TELEPHONE 2, , INCOME (LOSS) FROM OPERATIONS (241.84) NET INCOME (LOSS) S (241.84) See accountants' compilation report. OSWALT & ZARRO - CERTIREO PUBUC ACCOUNTANTS

6 W. DAVID THOMPSON, M,D CORONER-PARISH OF RICHLAND STATEMENT OF CHANGES IN PROPRIETOR'S CAPITAL- INCOME TAX BASIS For the Year Ended December 31,2013 PROPRIETOR'S CAPITAL BEGINNING OF YEAR NET INCOME (LOSS) 16, (241.84) WITHDRAWALS (12,000.00) PROPRIETOR'S CAPITAL- END OF YEAR 4, See accountants'compilation report. OSWALT a ZARRO - CERTIREO PUBUC ACCOUNTANTS