Form 205 - Collector'S Annual Settlement

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MISSOURI DEPARTMENT OF REVENUE
FORM
TAXATION DIVISION
205
P.O. BOX 453, JEFFERSON CITY, MO 65105-0453
(573) 751-5858
TDD 1-800-735-2966
(REV. 09-2010)
COLLECTOR’S ANNUAL SETTLEMENT
PAGE 1 OF 3
ANNUAL SETTLEMENT OF
, COLLECTOR OF
COUNTY
FOR YEAR ENDED FEBRUARY 28, 20
.
SUMMARY OF CHARGES
SUMMARY OF CREDITS
AMOUNTS
AMOUNTS
TOTAL CURRENT*
TOTAL COLLECTIONS
TOTAL BACK AND PROTESTED
TOTAL DELINQUENTS
TOTAL OTHER
TOTAL ABATEMENTS
TOTAL PROTESTED
TOTAL REFUNDS
TOTAL CHARGES
TOTAL CREDITS
TAX BOOK DIFFERENCES
TAX BOOK DIFFERENCES
GRAND TOTAL CHARGES
GRAND TOTAL CREDITS
• TOTAL SURTAX IN THIS AMOUNT IF NOT
SHOWN AS A SEPARATE DISTRIBUTION
DISTRIBUTIONS
STATE
GENERAL REVENUE
SPECIAL ROAD AND BRIDGE
HEALTH CENTER
SCHOOLS
CITIES
SURTAX
ASSESSMENT
COMMISSIONS: COUNTY
OFFICIAL
SUBTOTAL
SUBTOTAL
TOTAL DISTRIBUTIONS
I,
, CLERK OF THE COUNTY COMMISSION OF
COUNTY
HEREBY CERTIFY THE ABOVE AND THE ATTACHED TO BE A COPY OF THE ANNUAL SETTLEMENT OF THE COUNTY COLLECTOR WITH THE
COUNTY COMMISSION ON THE
DAY OF
, 20
,
FOR THE YEAR ENDING
, 20
AS THE SAME APPEARS OF RECORD IN MY OFFICE.
IN TESTIMONY WHEREOF, I HAVE HEREUNTO SET MY HAND AND AFFIXED THE SEAL OF THE COUNTY COMMISSION OF
COUNTY. DONE AT MY OFFICE IN
THIS
DAY OF
, 20
.
CLERK OF COUNTY COMMISSION
This form is available upon request in alternative accessible format(s).
MO 860-2231 (09-2010)

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