form 205 collector's annual settlement2015 land tax book from tax book from additions from fcl...

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Total Current* Total Back and Protested Total Other Total Charges Tax Book Differences Grand Total Charges Form 205 Missouri Department of Revenue Collector’s Annual Settlement Annual settlement of __________________________________, collector of _______________________________________ county for year ending February 28, 20 ___________ . Amounts Amounts • Total Surtax in this Amount if not Shown as a Separate Distribution State General Revenue Special Road and Bridge Health Center Schools Cities Surtax Subtotal 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 ________. Form 205 (Revised 12-2015) Clerk of County Commission Total Collections Total Delinquents Total Abatements Total Protested Total Refunds Total Credits Tax Book Differences Grand Total Credits Assessment Commissions: County Official Subtotal Total Distributions Summary of Charges Summary of Credits Distributions

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Page 1: Form 205 Collector's Annual Settlement2015 Land Tax Book From Tax Book From Additions From FCL and PILT Payments 2015 Railroad Tax Book From Tax Book 2015 Personal Tax Book From Tax

Total Current*

Total Back and Protested

Total Other

Total Charges

Tax Book Differences

Grand Total Charges

Form

205Missouri Department of RevenueCollector’s Annual Settlement

Annual settlement of __________________________________, collector of _______________________________________ county

for year ending February 28, 20 ___________ .

Amounts Amounts

• Total Surtax in this Amount if not Shown as a Separate Distribution

State

General Revenue

Special Road and Bridge

Health Center

Schools

Cities

Surtax

Subtotal

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 ________.

Form 205 (Revised 12-2015)

Clerk of County Commission

Total Collections

Total Delinquents

Total Abatements

Total Protested

Total Refunds

Total Credits

Tax Book Differences

Grand Total Credits

Assessment

Commissions: County

Official

Subtotal

Total Distributions

Sum

mar

y of

Cha

rges

Sum

mar

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Cre

dits

Dis

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ns

Page 2: Form 205 Collector's Annual Settlement2015 Land Tax Book From Tax Book From Additions From FCL and PILT Payments 2015 Railroad Tax Book From Tax Book 2015 Personal Tax Book From Tax

2015 Land Tax Book

From Tax Book

From Additions

From FCL and PILT Payments

2015 Railroad Tax Book

From Tax Book

2015 Personal Tax Book

From Tax Book

From Additions

Total Current Charges

2015

From Tax Book

2015

From Tax Book

2015

By Collections

By Delinquent

By Abatements

By Protested

Current Amount

Form 205 (Revised 12-2015)

Page 2 of 3

Current Amount

2015 Land Tax Book

By Collections

By Delinquent

By Abatements

By Protested

2015 Personal Tax Book

By Collections

By Delinquent

By Abatements

By Protested

2015 Utility Tax Book

From Tax Book

2015 Utility Tax Book

By Collections

By Delinquent

By Abatements

By Protested

2015 Railroad Tax Book

By Collections

By Delinquent

By Abatements

By Protested

2015

By Collections

By Delinquent

By Abatements

By Protested

Total Current Charges

Cha

rges

Cre

dits

Page 3: Form 205 Collector's Annual Settlement2015 Land Tax Book From Tax Book From Additions From FCL and PILT Payments 2015 Railroad Tax Book From Tax Book 2015 Personal Tax Book From Tax

Total Back and Protested

Other

From Interest on Taxes

From Penalties (Fees, 2% Add-on, Etc.)

From Interest on Investments

From Licenses

From Duplicate Receipts

2014 and Prior Protested Tax Book

From Tax Book

From Interest on Protested Taxes

2014 and Prior Personal Tax Book

From Tax Book

From Additions

2014 and Prior Land Tax Book

From Tax Book

From Additions

2014 and Prior Protested Tax Book

By Collections

By Refunds and Abatements

By Protested

Total Back and Protested

Other

By Collections

By Collections

By Collections

By Collections

By Collections

Amount

2014

By Collections

By Delinquent

By Abatements

2014

By Collections

By Delinquent

By Abatements

Back and Protested Back and Protested Amount

Form 205 (Revised 12-2015)

Visit http://dor.mo.gov/business/citycounty/ for additional information.

Mail to: Taxation Division Phone: (573) 751-5900 P.O. Box 453 TTY: (800) 735-2966 Jefferson City, MO 65105-0453 Fax: (573) 522-1160

Page 3 of 3

2014 and Prior Land Tax Book

By Collections

By Delinquent

By Abatements

2014 and Prior Personal Tax Book

By Collections

By Delinquent

By Abatements

Total Other CreditsTotal Other Charges

Cha

rges

Cre

dits

2014

From Tax Book

2014

From Tax Book