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-036 (JAN2002) Office of the State Auditor City Financial Reporting Form Cities Reporting Using the Cash Basis of Accounting Government Information Division Suite 400, 525 Park Street St. Paul, Minnesota 55102 Phone: (651)282-6114/Fax:(651)282-2391 E-mail: gid « osa.state.mmus Web site: www.osa.state.mn.us CLIENT'S COPY City of: Gem Lake For the Year Ended December 31, 2001 Please complete this form per Minn. Stat. Sec. 6.74 and return it with the city's financial statement by March 31 st. NOTE: THIS FORM SHOULD AGREE WITH THE FINANCIAL STATEMENT TOTALS. This report has been prepared from the records of the city and includes, to the best of my knowledge, all transactions for all funds of the city for the year ended December 91, 2001. indicate date. (ATrACH oaoirovrCE) 0 • •Please check if the duties of clerk and treasurer are combined per Minn. Stat. 412.591 Subd. 2. it change in status during 2001: Name Phone# E-mail Address City Clerk: Frederic a nu (651) 426-6443 Qemlakecity@aol.com Clerk's Signature: Date: Do total revenues of all fund s of thN Treasurer: Sarah . bian (651) 426-6443 city exceed $100,0009 Check on ,e "Yes HX Mayor: Paul R. Emeott (651) 429-5040 signature of Mayor or Treasurer': Date: Audit Firm: N/A Audit Firm contact: Expected Date to Complete Audit: Please check if change of address. City Phone# City E-mail Address City Mailing 1369 County Road E East (651) 426-6443 gem]akecity(cDaol.com Address: Gem Lake, MN 55110-5231 City Fax# (651)426-6444 ' The mayor or the treasurers signature is required. Per Minn. Stat. 412.591 Subd. 2, your city is required to have an audit if the duties of clerk and treasurer are combined and total revenue of all city funds exceed $100.000. 9 revenues do not exceed $100,000, your city is required to have an audit once within every five-year period.