Names of judges and clerks of elections at $______ per day (listing the names run in and not listing each name by lines, and at the end of the list of names giving the total of the amount of all the warrants issued for such election services).
Names of jurors at $______ per day (listing the names run in and not listing each name by lines, and at the end of the list of names giving the total of the amount of all the warrants issued for such election service).
(Name of Telephone Company for ______ office and total amount of warrants issued).
(Postmaster for ______ office and total amount of warrants issued).
By virtue and authority of the discretionary power conferred upon the county commissions of the several counties of this state to levy a tax of not to exceed 35 cents on the $100 assessed valuation the county commission of ______ County did for the year covered by this report levy a tax rate of ______ cents on the $100 assessed valuation which said tax amounted to $______ and was disbursed or expended as follows:
The statement shall show how the money was disbursed or expended and if any part of the sum has not been accounted for in detail under some previous appropriate heading the portion not previously accounted for shall be shown in detail.
I, ______, the duly authorized agent appointed by the county commission of ______ County, state of Missouri, to prepare for publication the financial statement as required by section 50.800, RSMo, hereby certify that I have diligently checked the records of the county and that the above and foregoing is a complete and correct statement of every item of information required in section 50.800, RSMo, for the year ending December 31, ______, and especially have I checked every receipt from every source whatsoever and every disbursement or expenditure of every kind and to whom and for what each such disbursement or expenditure was made and that each receipt or revenue and disbursement or expenditure is accurately shown. (If for any reason complete and accurate information is not given the following shall be added to the certificate.) Exceptions: The above report is incomplete because proper information was not available in the following records ______ which are in the keeping of the following officer or officers. The person designated to prepare the financial statement shall give in detail any incomplete data called for by this section. | ||
Date ______ | ||
Officer designated by county commission to prepare financial statement required by section 50.800, RSMo. |
Or if no one has been designated said statement having been prepared by the county clerk, signature shall be in the following form:
Clerk of the county commission and ex officio officer designated to prepare financial statement required by section 50.800, RSMo.
§ 50.800, RSMo