FLORIDA STATEMENT RE DELINQUENT AND ESCAPED LICENSE TAXES
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Florida League of Cities. Inc.
201 West Park Avenue
Post Office Box 1757
Tallahassee. FL 32302-1757
Telephone (404) 255-0424
FAX (404) 843-3216
Raymond C. Sittig
Executive Director
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June 30, 1994
Cynthia E. Goudeau, City Clerk
Planning & Development
P.O. Box 4748
r.learwater, FI. 34618-4748
Dear Ms. Goudeau:
We are enclosing herewith statement of delinquent and escaped license
taxes collected from insurance companies for your city by the League in
accordance with the agreement between your city and the Florida League
of Cities, Inc. Also enclosed is our check covering the balance due
your city as noted on this statement. If you have any questions,
please don't hesitate to contact us.
As in the past, this program has proven very successful for the
participating municipalities. We are continually researching and
contacting insurance companies which, according to our investigation,
owe license taxes to Florida municipalities, including your city. We
trust we will be able to recover additional revenue for your city from
these companies.
Trusting you will find the enclosed in order, and thanking you for your
cooperation in this work, we are
Sincerely,
FLORIDA LEAGUE OF CITIES
~e. ~aij:
~~ND C. S ITTfeJ
Executive Director
RCSjvwb
RECEIVED
J U l 0 5 1994
Enclosures
CITY CLERK DEPT.
OD - \ ''';':7- aD lV.'
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FLORIDA STATEMENT
Collections made for CLEARWATER, Florida
Company Name
American Interstate Ins. Co. of GA
Bankers Security Life Ins. Society
Calvert Insurance Co.
College Life Ins. Co. of America
Concord General Life Ins. Co.
Golden American Life Ins. Co.
Guaranty National Insurance
Harco National Ins. Co.
Houston General Ins. Co.
Humana Insurance Co.
Integon Life Ins. Corp.
Liberty Bankers Life Ins. Co.
Loyalty Life Insurance Co.
National Casualty Co.
Pennsylvania Manufacturers Assoc. Ins. Co.
Redland Insurance Co.
Shelby Life Ins. Co.
U. S. Financial Life Ins. Co.
Union Labor Life Ins. Co.
United States Life Ins. Co.
Wisconsin National Life Ins. Co.
Paid to
Years Paid For League
10/91-10/93 140.00
10/92-10/93 70.00
10/93 -1 0/94 70.00
10/90-10/93 210.00
10/91-10/93 140.00
10/91-10/93 140.00
10/93-10/94 70.00
10/92-10/93
10/91-10/92 70.00
10/91-10/92 70.00
10/91-10/92 70.00
10/88-10/91 980.00
10/91-10/93 140.00
10/89 -1 0/93 560.00
10/87-10/93 420.00
10/91-10/93 140.00
10/91-10/93 140.00
10/93-10/94 70.00
10/90-10/92 140.00
10/90-10/93 210.00
10/90-10/93 210.00
Total Paid to League 4,060.00
Total Paid to City 70.00
Total Collected 4,130.00
50X Due City 2,065.00
Less Amount Collected by City (70.00)
Balance Due City...Check Enclosed 1 ,995 . 00
Paid to
City
70.00
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INSURANCE PREMIUM TAX FORM
C/O CITY CLERK
FOR THE LICENSE YEAR 1998
FOR PREMIUMS COLLECTED IN 1997 BY:
PEOPLES SECURITY LIFE INSURANCE COMPANY
FEIN: 56-0267250
CITY OF CLEARWATER
112 S OSCEOLA AVE PO BOX 4748
CLEARWATER FL 34618
C/O TAX DEPARTMENT
4333 EDGEWOOD ROAD, NE
CEDAR RAPIDS, IA 52499
PERSON RESPONSIBLE FOR
PREPARING TAX RETURN:
DEBBIE KRUMM
MUNICIPAL TAX DIRECTOR
(319)398-8574
PHONE NUMBER
CITY OF: CLEARWATER
, FLORIDA
TAX DUE CALCULATION:
LINE OF INSURANCE:
LIFE
$
42426
ACCIDENT AND HEALTH
$
4354
TOTAL PREMIUMS
$
46781
LICENSE FEE DUE
$
75,
I CERTIFY THAT THE INFORMATION PROVIDED IS AN ACCURATE STATEMENT OF
THE PREMIUMS RECEIVED.
**TAXES PAID BY MONUMENTAL GENERAL AGENCY
GROUP, INC., BUT BELONG TO PEOPLES SECURITY
LIFE INSURANCE COMPANY. PLEASE ISSUE LICENSE
TO PEOPLES SECURITY LIFE INSURANCE COMPANY.
~~--\<'~
MUNICIPAL TAX DIRECTOR
01/19/98
DATE
,',ni..."i'dn.....l "l.hl,.-.H_~~ \.)1 ,,-JV, J.iIL.
.. Post c.)Tjce Box 32800
Louis\iUe, Kentucky 40232
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No. 0090563237
JAN 23, 1998
DESCRIPTION
AMOUNT
PEOPLES SECURITY LIFE INSURANCE CO - NAle 164475
56-0267250
75
Capital Security Life Insurance Company
Commonwealth Life Insurance Company
Peoples Security Life Insurance Company
Form 4659 (l2.97)
Please Detach Before DeposIting
::"::':'\
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER
:\1onumentaI Agency Group, Inc.
Post Office Box 32800
LouisviUe, Kentucky 40232
No. 0090563237
JAN 23, 1998
Pay SEVENTY-FIVE AND 00/100 ------------------------------------------
6O-16J
"""'4l3
To the order of
CITY OF CLEARWATER
112 S OSCEOLA AVE PO BOX 4748
CLEARWATER FL 34618
VOID AFTER ONE YEAR
$75.00
Monumeotal Agency Group, Inc.
APSLP
CITY008156
PNC Bank, National Asociation
JEANNETTE. PA
By:
Autho
1I100~OSb3 237111 1:0l.330.b 271: .00 .7l. 2l.bSIII
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INSURANCE PREMIUM TAX FORM
C/O CITY CLERK
FOR THE LICENSE YEAR 1998
FOR PREMIUMS COLLECTED IN 1997 BY:
CAPITAL SECURITY LIFE INSURANCE COMPANY
FEIN: 58-1640298
CITY OF CLEARWATER
112 S OSCEOLA AVE PO BOX 4748
CLEARWATER FL 34618
C/O TAX DEPARTMENT
4333 EDGEWOOD ROAD, NE
CEDAR RAPIDS, IA 52499
PERSON RESPONSIBLE FOR
PREPARING TAX RETURN:
DEBBIE KRUMM
---~----_._-----~
MUNICIPAL TAX DIRECTOR
J3J9)39~~~74__
PHONE NUMBER
CITY OF: CLEARWATER
, FLORIDA
TAX DUE CALCULATION:
LINE OF INSURANCE:
LIFE
$
82441
ACCIDENT AND HEALTH
$
4500
TOTAL PREMIUMS
$
86941
LICENSE FEE DUE
$
.-- ------
75
I CERTIFY THAT THE INFORMATION PROVIDED IS AN ACCURATE STATEMENT OF
THE PREMIUMS RECEIVED.
~~--\<'~
** TAXES PAID BY MONUMENTAL AGENCY GROUP, INC. BUT MUNICIPAL TAX DIRECTOR
BELONG TO CAPITAL SECURITY LIFE INSURANCE COMPANY.
PLEASE ISSUE LICENSE TO CAPITAL SECURITY LIFE INSURANCE 01/18/98
COMPANY. DATE
Pt>lit lo)fficc Box 32800
LouisviUe, Kentucky 40232
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No. 0090561992
JAN 22 I 1998
DESCRIPTION
AMOUNT
CAPITAL SECURITY LIFE INSURANCE CO - NAIC 179880
58-1640298
75
Capital Security Life Insurance Company
Commonwealth Life Insurance Company
Peoples Security Life Insurance Company
~~9~ 4659 (12-97)
Please Detach Before Depositing
Monumental Agency Group, Inc.
Post OffICe Box 32800
LouisviUe, Kentucky 40232
-,;
No. 0090561992
JAN 22 I 1998
Pay SEVENTY-FIVE AND 00/100 ----______________________________________
150-162
43J
To the order of
CITY OF CLEARWATER
112 S OSCEOLA AVE PO BOX 4748
CLEARWATER FL 34618
112 S OSCEOLA AVE PO BOX 4748
CLEARWATER FL 34618
VOID AFTER ONE YEAR
Monumental Agency Group, Inc.
$75.00
APSLP
CITY007350
PNC Bank, National AloWociation
JEANNETTE. PA
1110 0 ., 0 5 b ~ .,., 2111 I: 0 L. 11 0 ~ b 2 ? I: ~ 0 0 ~ ? L. 2 L. b 5 III