040254 Town Board Mtg
. March 5, 1954
All members were present at. the regular board. meeting of the TowIl
of heelsior held Friday the 5th of March 19.54.
The contract submitted by the Suburban Henneipen Count, ReUef
>>oard was read and adopted and signed.
A resolution approving the sale of Lot 15 >>lock 12 as pubUc . .
lands was also .P.r'. .._.Ii passed by the board.
Some further diSRssion followed relatiTe to the proposed budget
set at aspeeial meeting on March 2nd. The board decided to make
no changes in the reccommendatlon.
No 'OllIs were ordered paid except those 'OllIs for labor.
Respectfully submitted,
w. D. 1Cemdriek, Clerk
April 2nd. 19.54
"-
A rega1ar b'Oard meeting with all members present was ,held on Friday
the' 2nd. of April 1954. ..'
The board viewed aproposal to plat lots 98 and 99 Auditor's Sub: * 141
on and near Lake WiiUam. qthis was submitted by Mr.!eii :Bryan from
Wayzata. The board declined tcimake' a final decision at this time.
The :Board approved a motion by A. H. Claga~ that the oidipnces
of the town be assembled and that about 100 of these be run off by
mimeograph or other aethod. .
The bills aspresented by the cleEk were ordered paid.
Jiliu! Trick sugested that the board consider the desireability Qf
reqUiring a surVey before granting a permit to build. Walter :Bean
pointed out that as long as we did not have an ordinance requiring
compliance with a building code that the board had" nO controloTer
how or where a person built his residenoe.At this point Mr. :Burton
from Deephaven talked to the board about what Deephaven had lone
about abuilding code and platting ordinance. They appointed a.
planning commission which studied the problems. They passed an
ordinance with TeTy severe restrictions abou~ the she of the lot, where
the hOUse could be located etc. On'four specific tracts th$y had
lot size restrictions of 60,000 feet.
meeting of April 2nd. continued
Mr. and Mrs :Bisbee, the Orl1n JOhnsons, Jim Randall and others were
present to find out what if anything the board could do about the
annexation of the W,illiams property by Tonka :Bay. These reildents
were opposed to the annexation beca.use of the Ibct that they had
heard a liquor store was to be set up. Neil Grathwol stated the
case for t~e board reading decisions by the supremem court JIIi.
lt was conclu.ded that the board had not legal rights andihat any action
to quash the anneution would bave to be started by a .citben.
A motion was made by Al Clague that the board was h S1JIIPatb7 with
the residents.
"
The board then adjourned the meeting on motion by Walter llean to
April 9th. for the further consideration of adopting abuild1ne;
cOde
Respectfully
W. D. Kendrick.Clerk
1
Mi.tera of the Ann....l <<rown MettiDg
!twn Of .-.lsi...
Mal'oh9tb. 1954
The annual t4ee'1n,~ of 'l'be ,",eft of the Town .f ~.l.S..r_. M14 11l
tM Matonio ~mple DuU.d1ne in the '111~ of n%oeldW . !Me'" ,.
9th. of !~l'Ch 19St.. Mr. A....". lick aotad a8 _--.tor.
1'he Clerk read the minutes of the taataannual _.t1~ $ftd they"'.
appr_ed flS read.
TM Treasu:ter. Hr. t. O. F:rar,nes'J read hh report. Mrth Settnln m<<rred
tmt his report 'be acc4ipted. This va. .econd.d by rlt. ltf., and \11.
.otien carried. Theclerk'g r'<<tport was approyed. as read.
Th~ quentlon WB$ ral..d as to the M~anlng o~ the dec1910n 1n the
Cn1"t"lAechal Caf!U}. and Coa.n.el orathl~o1 SU'~!"Ied it up. The 'bOQrd has the
power to r{",l11ate. but not to probl~1t or put anyone out of 'butdness.
'Ph' question .1' 0: trailer Ol'dln.n11Co W~ also r1.d.sed.. nnd nt, llratht01
explnln'd the ler,al Bspeeta of such an ordinanoo. pointing oat that a
'1U~ner of ordinancns J'~1at1Ye to ... trailer!'; haa 'been dra~m up 'but
that none had Met with the approyal of the board.
The pos91'blUty of the Tmm ad.opti;nfP .n butldlnfP, code was discussed. In
thh con'1oct1on a question was r''lhed as to \.rhether or not the 'b'''nri,
c0l11d o'1force any of theseordlnanOl or codea. Hr. Orathwol pointed out the
need for a 'buUdlnl'; inspector if' a l1ut" dl~ code were adopted.. Mr. Beall
eX!)lalned the difference betwen a !lit ordinanCe and a ~11dJ~ Ol"dl~
A d1seussion 'betwMn Hr. Gle nn R09$ and Mr. ~'Ja.lter nean ensued about
the need for a f\111 tiM Inspector.. !~r.Orathwol told the groap what
D&el'ha...enand hland Park were Goinr; n'bout b\111<11n(' code.. such as
adoptinr the or'. H.I\. nul1dlnr:code, the State Sanitation OOde and that
thh was {one bzr roference. nrs. Sotnan then moved that the Board
In....9tir:at. &be 'bu.l1dl'l\f':' code matter and that they alsO :furthe1" look
into the n'latterof hotlsa tratlers. Hr. Ross Gald that thig waO only
postponing tNt Issue and that action should 'bo \.akenat once. Ur.s.
Setnan trUhd1"ew her !"lotion. 'but submitted ~ motion th'!lt the 'board pass
a. buHdtn,'" code as soon an pondble. ttrs. Ftc~':: seconded th1s Motion and
it wns carried.
Hr. Hos\'l "'OYed tLat the board also pasa a pt'E\tti~ ~,... ordlnanoe.
~~r. o.l18h Herrmnn seconded tbe Motion t,th1ch was pG.lsed.
The propeosed budrot for 195-",,",19"56 was pre.~nted b1' !fr. A. b. Ol9J$e.
Chr'1rts tlere set up to !1hot" the pers'ns prosEt!).t 'th':1t the ))oard. had done m t11
U"9 previous 'hndr'et. nnd to ~hO't'" '.dry the ne'.1rrOCOMet\dattons were mad.
'by the board. Hn told. the ('TOUp abottt tho '. urehaoe of a lo,~deJ". a new
truck .flnc1 nchain anw. and out1tnCld the plnnn of the 'b<><"lrQ for the
eomlnr yoar'
Glenn 'rans expre!1'Jed hit'! opOsitlc)'1 to \101'\0. !)j')l'n~:rlnr; coste a.,d the pro~aM
in I':Onornl. Hr. :Renn rQ\Curred. nO' moved MInt the 'board spend onl, 2.50.00
::or tleod 'rpr',:.riC'lf': in 10511. The qu('nt1o"l 0:: the le("lll1t;r Of3UCh a motion
''Ian raised. f1'd ln91,ito of the doubt th'1t it ,rag lora1. !1.nother motion to
!'\pend only ;';2;")').11'):'01' t18&d int' in 1(,.5!~ TJt9.fl secondod and paMed \!Len
"ut tD a voto.
pare a ,..90-54
Hr. Flck then .9k~d for ftWthu" que"tlOfla. 11r!h Oharles 'ray1..
asked U' it \lere pOAsl'blo to t1'IU"b (('rats :fires and to fix regJ'on-
stMllty tor them on the one 1;.;ho !let the 1'1" Q;)O make him pat' tl1e
costo. ~~T'. Orath~\101 snld that he f'El~ t the there ,Altt a cortain r09pcm.
afbil1t:.r on the part of tho OttO trho acts Q:"'1"aSfl fire. and that tlut
board could make tnom pn:r the C09ta.
Hr. liermann a~ked 1,!hv the b.on"d has re::.uced tbe !.oad and. n:d.d~
fuhd estimate for lq5~S6. Hr. l~ean anowrod that the board hoped to
hold the line on expenses in 19.54 and tila t the 'prrn~i0l19 b~t
(thnt 19 195h-"5) was ded~ed to paw-current e;q>ensee and to "fIi"1
off tho d.ef1c1 t in the ;oad. and rir1d~ ~ Hr. lioss c~tu1ated
the :Board on cuttinr: the bu~tbut s'id that be hoped It Hould not
"'0<1t tLe ezponse ot too labor C1"$W. He then MO'f'ed tbat the bud.eet
aa roc~:nded 'by tho :BOIU'd be accepted 121 1 tG entiret". Thh wa.
geconded b;: ~fr. Tricdc iH1d 1')1'l.9ged. The'Utl~t 1s a9 follows.
Road and. :Brtd~e :Fund
11ro Fo.nd
OonUneen_
Oeneral
U'are
i~~28,SOO.OO
Z,500..00
5,000.00
'3,000.00
,l.Q?o,,~
$IJO,ooo.OO
~~rs. ) tnan asked the board whf\t it was dolnr a"bOllt the park, 81.0 at
the Meotinlt of March 10th.. 19~. n motion was p.'l.ssed to tM effect that
ho bo'rd vould apl10int a COrJr1~, t e~;e to determine hOt~T rmch 1 t ,-!culd cost
to. mslntai.n ~~ parl-: I'lnd ])0991bl;r to ad6 thi'i'l COst to the next(1951J.)
f"'Udget. \'alter De!U1 lald that 21) do:t'bitt) action hnd been t~l1:en by the
:BO'1rd. but tL.ey were af"7'oeabl,~ to he1.p the rmnot eroup ~dth some or their
COlts and eJq)Ol'lsen aa 'bMt theXT were able.
Mr. Fiek then rel1(1, the reaulh "f the electio.n.
For Su:ne1"Yi sar. ~'ri' Georeo :Lont"Osk'o receivod .. .otes 68
yo.r Clerk ':i. KendJ"ick r$Coived" .otes 6S
To:r .Tustlee of h,rtee n1". l'\a:;
~ttornon
Hl". GladcP1 nar.\Je
ro.r Constable s"'r. ,1eanGray
rc1co1ved l~ votes
ree~l.od 2.otos
rec01ved 66 votes
There were 69 ballots eae'.
)11". Paxton "'~ th9.t the MGet1n~ be ad.J01.J..'lmed and this was second'"
and pas..d.
n.llpoctfUl~.
~11. D. JC'4ndrtakt 81_.
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VERIFIED ACCOUNT
No.-__,19_
CLAIM OF
J. E. Butterfield
Audited and allawed at I 7.06
this~~_day 01 April
Paid in Order NJ,,909
19_
Dated 19_
Road and Bridge Fu.nd
19-
Received Order No.
in
payment 01 the within account.
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Filed in my office this
day ot
19_
'!W"'I...~" ...OOT>1. eo", MINN&APOU.
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The Town of Excelsior
Hennepin County, Minnesota
195_
J. lB. :Butterfel1d
To
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parts as per attached 5.06
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I declare under the penalties of perjury that I am ...............................................................................................................
J. lB. Butterfield
(here insert title of office and n.m~ of firm if claim is by a firm or corporation)
the...................~.~!.5!A.........................._making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has been paid.
sign here Z Z :It X
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The effect of this verification shall be the same as if subscribed
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth " Son. Minneapolis
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VERIFIED ACCOUNT
)/0.
,19-
CLAIM OF
LJman Iamber
.Audited and aUawed at ,12.15
this 2 day 01 April
Paid in Order )/0.1907
19 54
Dated 19_
Road and Bride. :rand
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Received Order )/0.
in
payment 01 the within account.
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Filed in my office this
day ot
19~
W"'I...TE" ...00'l"H .. eoN, MtMHlt...PoW_
The Town of Excelsior
Hennepin County, Minnesota
195+-
Ly. an Lumber and. Goal COII'p8DI'
To
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12.15
II1s.1 materials
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- D18eoW1t_______~___ I - ---J.3591
Bal.!lnce DUji _+_ $12 1S '
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I declare under the penalties of perjury that I am ...............................................................................................................
-.......................................................................................................H~.lni...t.Q;r.................................................................................
......................................
(here insert title of office and n.m~ of firm if claim is bv a firm or corporation)
the....................~.~~.!..............................'"making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law;.-J.1nd that no part of said
claim has been paid. ~ ~~ ~ de> .
D%X% here ................,..........................S.i.~~~t~;...~f..ci;i;;;tfZ7S~j~
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.B.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth Be Son, Minneapolis
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VERIFIED ACCOUNT
)(0.
,19-
CLAIM OF
Country Club Oil COIIp&D7
.1udited and aUowed at I 9.29
this~__day 01 April 19~
Paid in Order )(o~90S
Dated 19_
Roact aad irl4ge
19---
Received Order )(0.
in
payment 01 the within account.
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Filed in my office this
day of-
19_
"''''I..TCJIl e.~on''1 . _ON, MINtfCAPoU.
The Town of Excelsior
Hennepin County, Minnesota
195_
To COlmtry C} 'Qb Oil CQIIlPf'Bl'
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I declare under the penalties of perjury that I am ...............................................................................................................
H. G. Murfin OWner
(here insert title of office and namll of firm if claim is by a firm or corporation)
the...............................:.~~......................".making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of th~,!,-l~ therein charged; that the fees
therein charged are official and are such as are allow~.by/law; and that no p~,l(f said
claim has been paid. . '.'.'.../.;:..~t.. .~. ;' ;1 , ' '.. <",/o"
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'fhe effect of this verification shall be the sa:~..:(~:::~~r:~g:~tu:~:.~~...~:...:.~~:...::~~~
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth" Son, Minneapolis
Dr.
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VERIFIED ACCOUNT
No.
,19-
CLAIM OF
Power Tools Illc.
Audited and aUawed at I 27.33
this~___day of April 19_
Paid in Order No. 1898
Dated 19_
Road aDd ~ridg.
19--
Received Order No.
in
payment 01 the within account.
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Filed in my office this
day 01
19_ '
~"'I..TEIIII ..-.00"'". _ON, M"'NC"'Po~
The Town of Excelsior
Hennepin County, Minnesota
195~
To Power Tools 1M.
17.31 University Ave.
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I declare under the penalties of perjury that I am .............:~......_..L.\.J.I::;;r:0................................................................
acting for the
.......................................................................................................................................................................................................
...........................................................
(here insert title of office and name of firm if claim is by a firm or corporation)
the........................~.~!~.............................'"making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has been paid. ~) _ ~ .0 ()
:ax ........................~':::......:..~~;t~..~~.v.k:1i..x...M....,.......
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.B.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth 3. Son, Minneapolis
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VERIFIED ACCOUNT
No._~__, 19-
CLAIM OF
ChanhaBBen Garage
Audited and allawed at I 1. 15
this~_day of April
Paid in Order No. 1904
Dated
lioad and Jrid&e
Received Order No.
payment of the within account.
~
Filed in my office this
day of-
19_
~YC'" ll.aoOTH. eoN, "'INNIlAPoU.
19~
19_
19---
in
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The Town of Excelsior
Hennepin County, Minnesota
195_
Ohanha.Ben Garage
To
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....................mm...........................m.....~.~.....~.~.....~~~.~.!JI.......~.'-r........m.m...........................................................~....................................
...............
(here insert title of office and name of firm if claim is by a firm or corporation)
the...........................~~~...........m...........~making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has heen paid. sign here .__.._r:l..~....']!.:~._'.;1~...;,,"k,"'____
Signature of Claimant ..7
The effect of this verification shall be the same as if subscribed and sworn to unaer oath.
M.B.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son, Minneapolis
Dr.
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VERIFIED ACCOUNT
}lo._~_, 19-
CLAIM OF
'irctala Xenirlsk
Audited and aUawed at I 10.20
this 9t~_day 01 Marsh 19~
Paid in Order }lo. 1876
Dated 3-9-.54 19_
GENElU.L J'Ul11)
19--
Received Order }lo.
in
payment of the within account.
~
Filed in my office this
day of
19_
~"'I..TC'" ..~oni. eoN, MIHHCAPoU.
The Town of Excelsior
Hennepin County, Minnesota
195_
'tJreida Xeuri.k
To
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12 h.ure ae Juice .t .1..tien March 9. 1954
.. .85 per lILev
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I declare under the penalties of perjury that I am ...............................................................................................................
..............................m...........................................!.!~c.!~~....~.~.~.~);.......................................................................................................
..................
(here insert title of office and name of firm if claim is by a firm or corporation)
the..............p..~.~.~.~~..........m....................making the within claim; that I have examined said claim and
(here insert person or firm)
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that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowj;ld bYlaw; and that no part of said
elaim ha, beon paid. _._?/:utrud..~---~~
rl Signature of Claimant
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son, Minneapolis
VERIFIED ACCOUNT
Ho.---,19_
CLAIM OF
Aliee UUpcr...
.4udited and allawed at I 10.20
this~~~day 01 Mareh 19 S4
Paid in Order Ho. 1875
Dated 3-9-54
19_
aG1i!R'1l!R 1.t. J'UllD
19..-_
Received Order Ho.
in
payment 01 the within account.
~
Filed in my office this
day 01
19_
w...I...~" ..800T>1. eoN, ...INNE...~U.
The Town of Excelsior
Hennepin County, Minnesota
195_
.All.. UHr..
To
12 Mare a..1.r~ ef 'WD e1..t~~_ __.85
10.20
_ h _
--t-
II
_ ------------------jt---------
I!
lL
~-
~-
1:
,..:1
------ -:r------'
---..------ _-=1'1-
-..--- -..
_._..,-~--_._~_.. ...,.... -~,
"'-'"'.-.'~~-=,,< .-____"T~,.._<<~~-_~_,.,_____..",..~....,.,,_<~.
I declare under the penalties of perjury that I am ...........A~.~~.!....~!...........................................................
p
(here insert title of office and nam!! of firm if claim is by a firm or corporation)
the.............p.t.r.!IP.!.~................................~.making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are all9:wed by law; and that no part of said
claim has been paid. /M _' _ c.::"')
....L:.........~;.:?~::~:::.~~~~;~.!~...................
The effect of this verification shall be the same as if subscribed alia sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son. Minneapolis
Ii
II
, II
,.. ____)1
Dr.
-11
~1!
J
iI
I!
'I
{,
VERIFIED ACCOUNT
Jlo.--_,19_
CLAIM OF
I.YerT hek
.1udited and allC1Wed at I 5.00
this 9--___day of Marek
Paid in Order Jlo. 1876
Dated 3-9-54
Gtt.eral hat
Received Order Jlo.
payment 01 the within account.
~
Filed in my office this
day 01
19_
"""'L~" e.-.oo-rH" eoN, ......N....PolJe
19~
19~
19--
in
The Town of Excelsior
Hennepin County, Minnesota
195_
To
A"'.rr Ji.k
If-------- -
__._r_'".__,__..
- . .....--~-~._._-~ "-'~--~--., --_._~
~ ~.='7~ '~~._.__I;
-_.J:
j;---..
.),...---.ni......a. .....rat .r .-U'-.UJL1I&l...t..ft1l. ....t.1aC-
I .e1i 3-9-54-
_1.
IL
"
f:
.-~_".,'.,.__..z"'..,"'.,.._.___.,..~__;,"'~~,.._..~~,.._""""".......".~''-';'
I declare under the penalties of perjury that I am ...................Ay.tJ.:z...l1...k.......................................................
(here insert title of office and neme of firm if claim is by a firm or corporation)
h p.r... k' h . h' l' h I h ' d 'd l' d
t e...................................................................~.ma mg t e WIt m calm; t at ave examme saI c aIm an
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
:::m,:~:t h~:~~i~i:erifi,ation shall he th, ,~~-::~~~~~::-~~-:~=::.
M.S.A, 471.38, as amended by Laws 1949, Chapter 416,
66 Size I-Walter S. Booth & Son, Minneapolis
-i'
JI
5.00.~1
If
Dr.
jJ
d
ii
11
j
I
-1
VERIFIED ACCOUNT
No.---_,19_
CLAIM OF
AaAa 01...
.Audited and allowed at ,10.20
this~~_day of Mareh
Paid in Order No. 1874
)-9-54
Dated
'J1l1ERAL :rmm
Received Order No.
payment 01 the within account.
~
Filed in my office this
day 01-
19_
W......TE" a..con.. .. 80N, MIN'u!:lt.Poua
19~
19_
19-
in
.
....
The Town of Excelsior
Hennepin County, Minnesota
195_
.lana Olsen
To
~-_._-.._:-:=;~,.-c:=::..'.'~~==::'_~_.
:--==: !--il
, j'
~ ]
,----- "
-- -- .---.. - ., t-.
12 heurlt all_~4!__.~! t~._!!..t1!~_.a:, $.85
10~20
_..--_....~.-
I declare under the penalties of perjury that I am ...............................................................................................................
Aana 01e8.
.......................................................................................................................................................................................................
...........................................................
(here insert title of office and namll of firm if claim is by a firm or corporation)
the................P!!':!.!~............................."making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed Uy law; and that no part of said
claim has been paid. ....................~......(...:.z.~:.:.:.~....r.O~
Signature of Claimant
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.S.A. 471.38, as &mended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son, Minneapolis
Dr.
I
I
nl
I:
-11
II
jl
J
VERIFIED ACCOUNT
No.-__,19_
CLAIM OF
Audited and allcnved at I
this
day 01
Paid in Order No.
Dated
Received Order No.
payment 01 the within account.
~
Filed in my offtcethis
day 01
19_
"""'-TlI!:. ...oort1 . eoN, MIN"II:",PoU.
19_
19_
19--..-
in
The Town of Excelsior
Hennepin County. Minnesota
195~
MlImETONKA. State Bank Agency
To
Dr.
I
"'--'~- !
'3/9/4i4 I Bonds ~7 15m
---.. l
I
, Cl@.rk
-_._---~._.- ,,-
~ _ __Q~nstable -
I Justice of Peace
I ,-
i -,
-......-..
,-. ...m......._
..-
i
I .....----- ._-""~-<.~-~-
i
I I
--------------.'"-. .. "--~- _. ....
---- -- - n"~.
-- I
_. .. m_
-~-, ...."..
I declare under the penalties of perjury that I am ...............................................................................................................
.........~~.~..........................................................................................................................................................................................
......................................
(here insert title of office and neme of firm if claim is by a firm or corporation)
the~.~~....~.~~~~....~~~...~making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has been paid.
Signature of Claimant
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth lie Son, Minneapolis
VERIFIED ACCOUNT
No.----,19_
CLAIM OF
Country Club Servtce
4udited and aUawed at I
this~___day 01 J'eb.
Paid in Order No. 18,54
:31.84
Dated
ROad and :Bridge
Received Order No.
payment 01 the within account.
~
Filed in my office this
day ot
19_
'l!O'''''-~'' .,~OTH. eoN, ""HH~"'PO,-j.
19 54
19_
/9-
f
in
j'
The Town of Excelsior
Hennepin County, Minnesota
195_
Ceuntry Club Service Statio~
To
-~~~l eas.l_ine ~~has_!S
,----un
,~-,u<-'-r,,!,--' !.
' ,
, ,
, '--'-'-~-'-.-11
31.64 "
" t--h
.,
ii
I'
u----r
I~<
L
I
I
'i'--
!
'--'---"j--'" t-.-.-.. ----.-----
Il..___ I I
I I '--r
!~--~-'--I
Ii I
11-- ~-~ ~ -- t - - ------ - - ------.-----
~l. .s. t~et. ~ r.tU1'll-~~_~=___=--- .
i
, '
- -~.<-_-- -~----~-~ ~-~----
--,-- '-"'---~_.,- ..-
.~=- ......l~.
-- " _-3=-
I declare under the penalties of perjury that I am ......................!.~.~....~~~~~.~..........;.......................................
Leasee of Country Club Service Station
.......................................................................................................................................................................................................
...........................................................
(here insert title of office and nam!) of firm if claim is by a firm or corporationl
the..................f~~................................"making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and tha 0 part of said
claim has been paid.
x
The effect of this verification shall be the subscribed and sworn to under oath.
M.S.A. 471.38; as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth" Son, Minneapolis
Dr.
J..,I
~I
Ii
..'il
'I
Ii
d11
j
..j
VERIFIED ACCOUNT
NO.___.___m_____________._n...__' 19m_____
Claim of
Audi ted and allowed at $______________..__...mm______m.
. this m__n_________ day of _____m.___m__m___________., 19___.____
Paid in Order No. ....mm...mm__..._.._m.m.
Dated __________________.___________________________, 19________
___n_________________________________________________mm 19________
Received Order No. _n__mm____m__mm___. in
payment of the within account.
Filed in this office this m_________m__mm_____
day of _____m_____m_m__m_mm__mmm___m_m__' 19.__.____
~. ..~+.,.,-~
;.--.
.i~
The _ of Excelsior
Hennepin Connty, MinnesOlta
19.5.4.__u.___
Jan.
21
Clean and check plugs
Intall Points
1 Set FAA 12171 lID Points
1 7RA 12.300 Condenser
&tatt of .ffliuutsnta
\r ss
County of Hennepin
DUDErOF EXCELSIOR
-'TOwnsliip
. . . . . . . . . . . . . . . . . . . . . . . . . . L.. .R.. . Laramie. . . . .
To ____.__.Ml.r..mi..__.to.rll.,.,..InC.....,__,:..".......r.
1 :00
2 '15
1.70
75
620
. . . . . in said county and state, being duly
sworn, on oath says, that he is Presiden:t. st. .tarame. .JkrtiQrs,. .IJ1C.
the person named in the above account; that such account is just and true;
that the money therein charged was actually paid for the purpose therein
stated; that the property therein charged for was actuaJly delivered or used
for the purpose therein stated, and was of the value therein charged; that
the services therein charged were actually rendered and of the value therein
charged; that the fees or accounts charged therefor are such as are allowed
by law; and that no part of such account has been paid.
Signed~~~~.......
Subscribed and sworn to before~his" 2nd.. .day of . ,~"bnar7. 1954.
.htarT . pu11J;~ ~~~~;;;.;;,.. .b.
lq commission Expires 1/19/56
I'
No.................................................
. VERIFIED ACCOUNT
.11 m-ount Clai7neit, ,....... .....................................................
.11 ccount VB.
.I1udited ana alluwed at I.............................................
thil... .... ... ..... ... ......;1017/ 01............ ...... ........ ...... ..........19............
Pa,ifl in.......................................No...........................................
Datea........................................................................19............
........................................................................19............
.'lec6ived....................................... No.................................. in
payment 01 the within account.
Fi~ in """7/ offi,ce thM......................................................
da;g 01....................................................................,... 19.;..........
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No. IOl3-VERIFIED ACCOUNT
Killer-Dana Co.. Kilmeapolia
Februar.y 26,1954
.....................................................................................................................mJ.9.............
r UCELSIOR TOWNSHIP
...................................................................................................................................................................
SUBURBAN HENNEPIN COUNTY RELIEf ..Io-S~li,;;..................................................................................._.......................m................................
12D NINTH AVENUE SOUTH
To.'................................~~~~.!.~~.~..~.!.~~.~..............................................................................................................................................
...........Dr.
Relief Orders tSfted
1
II
II
Ii
. 127.'3
Ii
Ii
Ii 17."
, 145.29
!:
Ii
~
II
II
II
I,
I,
Ii
11
!i
II
~'i
II
il
~l
I!
Ii
II
Ii
!
II
!
UtIXI' DPENDITURlllS lOR MONTH OF DBRUJ.RY, 1954
Aim1n1stratiTe Ohare-_
Total
l '!lIJ:l I ~ "l:l .... ~ ~
... i. ~ ~ r ~ ~
a:
f f ... ~
... ~. ~ t3
.. t3 r ~
"'" "'" ~
~ ~ ~ ~
~ ~ ~ ~
~
~ : ~ I ~
~ ~
s. .,..
[ ~ ~
"'" f ~
"'" ~ ~ r
r ~
.. i
I ~ ~ >
~ ~ ~ ~
~
0
L:
;. Z
"" ~ ~ i...
~ r r ~ t-3
t
~.
..
STATE OF.........X1.Q..I.O.~A.................................t
COUNTY OF............~.~~.~~.~................................. ~ 88.
Rita Elmquist . .
..................................................................................................................................................., l1ei7r-t du'ty tIW01'ft" deposes
and saYtJ he UJ th6
............:...~.~9.~!.~p..~.;-.......ol t1wl...............~~~.;'~~...~!~~!P..~~....9..~.~...~.~.;.!.!!'...~.~.!~...........................................................................
that the within, accoun,t is JUBt and true, t1t.at 1M ~ t1wlrein, men,tio7Uld were actua't'ty re7Ulered and of
the value oharted, that tM 100d8 th.er6iA tiho,rl,ed UlW6 aduaUll delivered and of t1wl value therein, oharted; and
that 7W part of the ,ame. 1uu beeJt paiiL.
..:~....I2~h...Uk.?:Y~N...................................................54.
8ubsoribed and I1U101'7I, to belO1VJ 7114 J;..;~~~.::;..........._. ;..../J....dai2".............................. ................................. 19...........
MAS' y . ;;// , f
1'1, ' ", ~ . /~-. .... ........ ............. ..... ....... ... .........................................
vl,,:;... \." ,_ . '/
14.1'''' ~~~<' : ':''1
~~u.1J
t,>(~ 1JJ~: t 'if' ~~1'!
~"tor. 21 -;.~;~.
, &.Ii7Uf).
M 11 OqmmifltJio.", e;x;p;,res....................._..............................19............
XotD,rpJ PuJilio,........_.. .......................................................Coun,ty.
, ,{k
'<l'.
SUBURBAN HENNEPIN COUNTY RELIEF BOPJill
Hopkins) Minnesota
MONTHLY ST ATSMENT OF RELIEF EXPENSES
--,-,-,,---_.~"-_..,'- -
TO:--.Eb ~ ~~
2. Administrative:
~
~ j;l.(P /S,/
If U
+~_ ~&-11s'l
$ /:2. 7,tcJ
Direct Relief Cases_ ;Z $ j 7 ' ~ (,
$..
. $-
DATE.
Relief Expenditures for the Month of
1. Relief Orders issued as per attached list of clients
3. Administrative Minimum Charges
4. TarAL RELIEF & ADMINISTRATIVE COST,
/L/5,2.i
1. LESS Credits as follows:
a.
$
$-
$.
$.....
b.
NEI' amount charged you this month
2. ADD Past Due Accounts:
c.
$
$
$
$
a.
b.
BALANCE UNPAID TO DATE OF STATEMENT
$
/ ,-/5, ;l.i
Respectfully submitted,
SUBURB.
I ~~: BOARD
epflC. Vesely, S~9retary
BY
. ,~':-~:~ :..~. :, 5. ':~,.L
"., .....~ .
.-...-.. ..... .,'''::':'.~.:,
.
:i;"-'" .;.'
..
. ,-,f :;.::.
';,;:'
~~
. .',.,"
..:. -Lt.
.~ " ,
. :-;,'~"!{)~ L
.,......... .... .-j
-.. :. :.:-::.~;. :. ~ .:";"" '"
............. "..~" ~....",,' ..Or'_."
.......... ..',--"
..._. ...(..../.......:-........~.._-... ......-
............~..-
'r~:,.,.".. i'
.,_.J
....-..'i"...
..........,..(.
,..'. ..
f"
..J.........
.!.",-.
-- ~. ,'" ........ '.....,
::-:::-'.:'-~-"
..~ . \. ....
. '.;........... ..........h'
. ~.,,;._..i...~ ...
".. -".......-'..~,....
....,........
.~. :..
.J.
I
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f
,
,
,.., '1' ..-......~.
I
......... '~-"""-"-"--
.~.. '..._~_......."........_.-.,,..... ..
........~'....
,:."::~,:~.~~:.:'::'::='::':~~::;;"""';:_:-'. :=::::::.:.'=o<:~~'
.. :.2_ :
,
.........
....t'..............".-..........
....-"'.-1.-..... ....--. ~.._........"<
....-.-..,!......
"':'.."....--.....
................
-~. .,..__...,-.-,
~ ~ . ..-..--..,.,-...................;............... .....--.......
-_....._...;"";.,..........._--_._~,...
.....,...__........_~,.......' -~~
..--........[-....-...-.+.
_...~~._~ .-.-....;. '.... '.-....
. ..~ .....~.....
..... ~'.--:" H.7:.....
..'<~..-,.... . '--~',
..............,.".....~'"
... ..._.-..-.-~. ....-.....---....~......,-
".__,..,i.. ._..
.._.. ".
...- ,
...... .---...-~.................
. "-...-..--.....::'......
SUBURBAN HENNEPIN COUNTY RELIEF BOARD
120 Hinth kvenue Scuth
HODki:lS ,. Hir:.nr::s.-:ta.
... J ,
MONTHLY STA~El{s~IT OF R~S!EF EXPENSES
.........__...____..__~.i_..~__.._____.
TO: Ch ~~
n;iTE_ . g/oZ'J lor,!
?h~ -/~5'
..' '"
Relief Expenditures for the Honth of
1. Relief Orders issued as per attached list of clients $_ 3 3 /. 75
2. Administrative ~ S .,.__Direct Relief Orders~~ if / . ;>.. 6
3. Administrative lIinimum Charget.__
$
.._-_$
J 7~ · r s
4. TOTAL RELIEF & ADHINIS'l'RATrm COST
1. LESS Credits as follows:
a.
$
NET amount charged you this month
$
$
b. $
2. ADD Past Due Accounts:
a.
'.J.d., ~
$
/ If 5'. ;J.. 1
b.
(~
i;i>
c.
$
$
B.ALANCE UNPAID TO DATE OF STATEHENT
_ $._~SI i, '-Lf
~--_...._..._._......__._.""-"-
I'~~~.
~.
Respectfll.lly Sl1bm~'.tt.ed,
SUE1:.JRBAN nF~iNID~j.!:.c"J C\)'Ji'ii'j'y R1~1IEF BOARD
/. .tfl(
~~V~elY," ~tary
By
.
SUBURBAN HENNEPIN CaJNTY RELIEF BOARD
Hopkins J Minnesota
. STATEMENT OF RELIEF EXPENDITURES
FOR MONTH OF ),fareh.19514.
Excelsior Tonship
Township or Village
BREAKDOWN OF RELIEF ISSUED
CLO- , \ PUB. ' NED- REST ALL
I
CLIENT'S NAME FOOD RENT THING FUEL UTIL ICAL HOME CfrHER TarAL
I
j
Mann. Lloyd. Jr. :Bo~:rd &, Ro~m for ~a'by Se tt -1 58.90 I
I r
I I ! ,
)(e Kinley-. Frank: 14.7.10 i i l5.~ 62.14.0 I
i
! ! ! ll1.o.~5 !
Ross. James Reimbt rsement for rElief' is med
I
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TOTALS I i I .~ 331.75
I i I I
VERIFIED ACCOUNT
){O,__~______, 19_
CLAIM OF
.1udited and aUowed at I
this
day 01
Paid in Order No.
Dated
Received Order No.
payment 01 the within account.
~
Filed in my office this
day 01
19_
WAI...TI!:lIII e..BOOTH. eON, M.NNlE:jIo,..O.....
19_
19_
19--
in
The Town of Excelsior
Hennepin County, Minnesota
19SJL
To
Ml'l Flpn Motor Co.
Dr.
_3-~?-24_
3-15-54 i
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15437
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I declare under the penalties of perjury that I am ...................~~.?~...~?~S?.!.:....9..~.!......................................
(here insert title of office ~nd nam., of firm if claim is by ~ firm or corpor~tion)
h - Me. son Motor Co k' h 'h' I' h t I h . d 'd I' d
t e....................................................................ma mg t e WIt m calm; t a ave examme sm c aIm an
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes' therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged' that the services
therein charged were actually rendered and were of the va~~'. ". .tTrged; that the fees
:\';i~i~a~h~~~~;:i:. offiaial and ",e ,nah as ~:_~_:ll:~l{::::__~_:_::_~~_~:::
(~ture of CI~im~nt
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-W~lter S. Booth & Son. Minne~polis
VERIFIED ACCOUNT
)(0.--___, 19----
CLAIM OF
I..'l. ~,A 7111',"
Audited and aUowed al ~
this ~ day 01 ~
Paid in Order )("17~
Dated
Received Order )(0.
payment of the within account.
~
Filed in my office this
day 01
19_
~"'LTl!:" e..OOT.. . eON. MINNIE:""OU.
19_
19_
19_
in
The Town of Excelsior
Hennepin County, Minnesota
195--1
Long Lake Farm Supply Inc.
To
Dr.
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.making the within claim; that I have examined said claim and
t at t e same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and no par f said
claim has been paid.
The effect of this verification shall be the me' as if subscribed
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Welter 5, Booth & Son, Minneepolis
VERIFIED ACCOUNT
No............................, 19.......
CLAIM OF
Audited and allowed at $ h..._..........................
this ............hday of - ..........._.._ m.h.._h.....,l!")......
Paid in Order No........-......................................
Dated ........ '"mm"hmm_''h''''' ......... -............, 19--.....
.......... ......... ...h.............., 19.......
Received Order No.............-.. in payment
of the within account.
Filed in my office this .....................:..................
day of ..............h...............m..........................., 19.......
The Town of Excelsior
Hennepin County, Minnesota.
............m....m... '''','m. ......... .......... ..........194.....
To....__.. .................... .................................................. Dr.
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State of Minnesota, }
County of Hennepin, ss
Town of Excelsior
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on, in ~tclCounty and State, being- duly sworn, on oath
.
says that he is. m..........._ ........ ....... . U_h.__' .....m............ the person named in the
above account; that such account is just and true; that t.,pe money thel;~in charged was actuallY
paid for the purposes therein stated, _ that the property therein charged for was actu~llY-,delivered
or used for the PUI poses therein stated. and was of the value therein charged; that the serv~ces
therein charged were actually rendered, and of the valli; 'tl~rein charged, that the fees or amounts
~l therefor arc such as are allowed by I:W; and that no part of such :ceount has been paid.
~9i~SY ~.
SIGN
HERE
. .
SUbscribed and sworn to before me this.
. .........day of.
.. .......19
VERIFIED ACCOUNT
No.
,19-
CLAIM OF
Audited and allowed at I
thi8~___day of
Paid in Order No.
Dated
Received Order No.
payment 01 the within account.
~ .
Filed in my office this
day 01
19_
...._Te:.III e..oon1 . .ON, MINHIU,.-oU.
19~
19_
19--
in
The Town of Excelsior
Hennepin County, Minnesota
195~
T - -.,
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Dr.
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I declare under the penalties of perjury that I am ...:::2f..tf!.f....::.....::-;;,........J..~....I..~!....f2.....t.i
.....~.....~........................................................................................;..................................................................................................
..................................................
(here insert title of office and name of firm if claim is by a firm or corporation)
the...................................................................~making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the prbperty therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that-no part of said
claim has been paid.
The effeet of this verification shall be the same as if subscribed and sworn to under oath.
l\LS.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth " Son. Minneapolis
02
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VERIFIED ACCOUNT
No.
,19_
CLAIM OF
Klanetanka aecord
.Iludited and alluwed at ,14.40
this~___day of April 54 19_
Paid in Order No. 1894
Dated 19_
General
11L--
Received Order No.
in
payment 01 the within account.
~
Filed in my office this
day 01-
19___
~,,",-Te:'" e.~or-I"I . eoN, MINIlI&.,POU.
, i'
'The T ciwS of Excelsior
.
Hetl'nepin County, Minnesota
195L
To
Mlnnetonka ReeJrd
Dr.
n---'''''====c'c~=
""=,,,-,,-,,~
,_~.,__u._..Ji
r NQY~_
p~lJ:lt1ng of legal, notlli:e~____
14._
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I declare under the penalties of perjury that I am ..,..................................................................................................-.......
....,............,.......................................................................~j;.~M...lD....~A'.....'"'~.~.".r.'.!it1t.!!!....9..t.........................................................
....................
(here insert title of office and neme of firm if claim is by a firm or corporation)
the..............................~~~......................~.making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was Ofithe, alue therein charged; that the services
therein charged were actually rendered and r" f the value therein charged; that the fees
:f:[.:;i~~h~~;~~:[d~ offi,;.l : are sueh as J-~ =1y::~~:l5::Ct\
, Signature of Claimant ~
The effect of this verification shall be the same as if subs ribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son. Minneapolis
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VERIFIED ACCOUNT
No.
,19-
CLAIM OF
V. G. Bacon Drug
Audited and alluwed at I 2..54
thi8~n!__day of April
Paid in Order No. 1890
Dated
General
Received Order No.
payment 01 the within account.
~
Filed in my office this
day of
19_
vrtALTlI!:" ...OOT>'!. BON, MINNll".OU.
19 :;..
19_
19--
in
'"''''''
The Town of Excelsior
Hennepin County, Minnesota
195_
V. G. Buon Druga
To
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8uppUesfor ~lr8t aid. k1 t _~.!"_~~tached.
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I'decl~r~---=n~er t~~-;=~l~;~~--~~-;erjury that I am .....cJ;..~.~.'t-J~~,........................~..............~--
...................................................................................~.~..~.~....f~.~....................................................................................................
.......................................
(here insert title of office and nllme of firm if claim is by a firm or corporation)
the.....................~.~~.~..............................Mmaking the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has been paid. / ~1 ' (' . I II
un ( I () { U2 (._":::;:H'~1.'
........t.;~.................s.i.~~~t~~;...~f..ci;i~.~~t..r.....................................
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.B.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son, Minneapolis
Dr.
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VERIFIED ACCOUNT
No.--__,19_
CLAIM OF
JtokeshBardwar.
Audited and aUawed at I 11. 95
this~_~_day of April
Paid in Order No. ; 902
Dated
Road and. :Brudge
Received Order No.
payment 01 the within account. ,.,,:
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~"'LTEIIt e..con.. _ eoN, MIN"'lEAoOOU.
19~
19_
19--
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in
The Town of Excelsior
Hennepin County, Minnesota
195_
To
Kokesh Bardware
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11.95
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I declare under the penalties of perjury that I am ...............................................................................................................
.......................................................ih~~~...i~~~.;t..titi~..~f..~ff:;.:~~~~i~;~...i.i..~i~.i.;;;..i;..b;..~...ii~.;;;..~~..~~~.~~~~ti;;-~i..........................................
......
the.....................~~~................................_making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are al owed by law; and that no part of said
claim has been paid. %XU . ... ...........w...~...~..J~
Signature of ClaImant
The effect of this verification shall be the sa e as if subscribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Size I-Walter S. Booth & Son. Minneapolis
Dr.
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VERIFIED ACCOUNT
No.
,19-
CLAIM OF
4udited and allowed at I
this__day 01
Paid in Order No.
Dated
Received Order No.
payment 01 the within account.
~
Filed in my office this
day 01-
19_
~""-TE. ....:'>0"1">'1. eoN,. M'NNaAPOu.
..... ~ , '
19__
19_
19--
in
The Town of Excelsier
Hennepin County, Minnesota
MIIDlTONXA State Bank Agency
19S--1l.
To
Dr.
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March 13 Julius G. Trick, Constable Bond $.500.00 .5 00
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I declare under the penalX\in~~t~er~t~? S:~~~ I B~~k...Ag;~.~y......................................................................-.......
......................................................(.h;~;..i~;~.rt..titi;..~f..~ffi.~~r;!:~..~jp.ifue'Pta.i;;;..i;..b~..~...fi~.;..~~..~~~;~~~.ti;;i................................................
the.....................................................................making the within claim; that I have examined said claim and
(here insert person or firm)
that the same is just and true; that the money therein charged was actually paid for the
purposes therein stated; that the property therein charged was actually delivered or used
for the purposes therein stated, and was of the value therein charged; that the services
therein charged were actually rendered and were of the value therein charged; that the fees
therein charged are official and are such as are allowed by law; and that no part of said
claim has been paid. n n f\ ^ ^ . _ _ if)
...~...~...~....:...................................
Signature of Claimant
The effect of this verification shall be the same as if subscribed and sworn to under oath.
M.S.A. 471.38, as amended by Laws 1949, Chapter 416.
66 Siza I-Walter S. Booth & Son, Minneapolis
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LATTERNER BROS.
RAY
EX. 565 W
SAND DRESSING GRAVEL
BLACK DIRT SOD EXCAVATING
BLACK TOPPING GENERAL TRUCKING
BULLDOZING SNOW PLOWING
ROAD CONSTRUCTION
DON
EX. 517 X
EXCELSIOR. M INN .__~_3p_________________l 9l5!)t
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STATEMENT
RECORD
EXCELSIOR, MINNESOTA
Phone: Ex. 870
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The Cle rk
Tov'lfn of Excelsior
'\V.D. Kendrick
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L .c:x eels ior, lVlinn
Jan. to bal.
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STATEMENT
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Form 105.53 P50 Poco 10M
THE PURE OIL COMPANY
I
L
JAN 1954
Division or Zone 5)10
Street Address 1306 So. 1st st.
City and State Minnea polis, Minnesota
IN ACCOUNT WITH
I
Excelsior Township
Road Department
Excelsior, Minnesota
~
We Charge
Your Account as FoI\ows:
110.8 Gals Gasoline
Less Fed gas tax on 110.8 gals 0.02
1 (U~l'fy, fh.'!' ~3-~ ..cove bill is con-cd and just and that
r:,-~""."" ." - ., 'I, ~l . !F~~ b""", .~~i":';;~ ;\~.;y
l _---?t!:.-~f~o:1f;; Chief Accountant
Subscribed and sworn to on this 11th day of
February, 1954.
C. F. WEBER
Nllta!V I'lJb,v HI::oneoiil ~ounty. Minn,
My gOmmission i;xpires Feb. 1, 1960,
TERMS:
No.
January
1 54
DATE
FEe 8 fl
FE8 1 7 54
COUNTRY CLUB OIL COMPANY
C ITI E $
CITIES SERVICE @ DISTRI BUTORS
SERVICE
METERED FUEL OIL DELIVERIES
PHONE EXCELSIOR 1234
I
Excelsior Township
Excelsior, Minn.
L
COUNTRY CLUB OIL CO.
(Please Detach This Stub and Mail With Your Remittance)
AMOUNT $
EXCELSIOR, MINN.
INVOICE NO. GALS.
CHARGE CREDIT
5 .3 .3 .5 7
219.93
9.29
ALL ACCOUNTS DUE AND PAYABLE ON 10TH OF MONTH FOLLOWING PURCHASE
BALANCE FORWARD
20.21
I
',Q 1954
;..r ',..1
195_
~
BALANCE
20.21
29.50
9.29
...
PAY LAST AMOUNT
IN THIS COLUMN
Quantity Unit
Description of JVl:aterial
/j
'2"
I
I
~
(!~<
-~. ;~:' ,"'-'~'''-'- -'~'
N9
Date
This purchase order must be attached to verified form and sent to the
Town Clerk before payment can be made.
Signed
Title
CUSTOMER'S INVOICE
CHANHASSEN, MINNESOTA
C. F. Schmieg, Prop.
General Repairing and Welding
;;7 . I DATEA~} . / 176-1
CUSTOMER r$ -fr'b~.'"l.> . ~ j,~ (
CHANHASSEN GARAGE
1816
Phone Excelsior 506X
ADDRESS
TERMS---
. Prices Subject to Change or Correction Without Notice
CUSTOMER'S SIGNATURE
e'T'"
@)
SERYICE
COUNTRY CLOB OIL
EXCELSIOR. MINN.
CITIES SERVICE PETROLEUM PRODUCTS
",HONI; EXC. 1234
~~~I~E~: ...
~~~v~:y ...
oN3 ~
"!V1S~
05330
CO.
GAllONS
TENTH.
-t-l0THS
-E-~bE~~E;~\~~y
~~~:; ~~A~i~v~RV
DATE
~/I/. &419_
,
'hl'\!sl.S.o~ fbfMchip
SOLD TO
ADDRESS
CITY
TANK TRUCK
SALESMAN
YOUR SALE NUMBER
# 1 RANGE Oil
#2 FUEL OIL
CASH
o CHARGe
TIME
GALLON READING.FINISH
BRODjE MASTH-NfPfUNf
. .
TOfALlZER MEIERS.
o
GALLONS DELIVERED
PRODUCT
PREVIOUS SALE NUMBER
DELIVERY RECEIVED IN GOOD CONDITION
SIGNATURE OF CUSTOMER
A.M.
P.M.
lOTHS
DATE
INVOICE No.
DEBITS
CREDITS
pcwetc ?ccU ~nc.
1731 UNIVERSITY AVE.
I
Excelsior Township
Excelsior, Minnesota
L
BALANCE FORWARD ItN"
1'54
22, 747
23.05
23,575
23,476
24.75
7.68
fEB 12154Rl
708
2<.3.15
STATEMENT DUE 25TH OF THIS MONTH
p~et J~dm;.
1731 UNIVERSITY AVENUE ST. PAUL 4, MINNESOTA
Telephone NEstor 7189
r
EXCELSIOR TOWNSHIP
EXCELSIOR UINN
L
DESCRIPTION
241 EDE CHAIN
-
DEPnt GAGE
INVOICE
I
-1
CATALOG
NUMBER
28188
t snll
I
~
No. 23575
INVOICE DATE FEa'11 .,.
SALES ORDER NO. 7843
DATE ENTERED FEI 115.
CUST. ORDER NO. Fa 1.15.
DATE SHIPPED 81.154
VIA It I CKED UP
TERMS NET II DAYS
SALESMAN
QUANTITY
ORDERED SHIPPED
01
05
01
05
I~
UNIT
PRICE
2415
12
AMOUNT
2415
24~1
. _I~_-
"A BETTER PLACE TO BUY"
LONG LAKE FARM SUPPL Y, Inc.
Wood Bros. Equipment-FORD TRACTORS-New Idea Equipment
Long Lake, Minn., ~./. J , 19d
~~. .
% Ui.J;}. r~.~
~,~.
No credit will be allowed on parts or equipment not returned within 10 days.
Debit Credit Balance
t i /0 s-,?
It / OJ?
/7 ~-
r ,
. 5'" t::.~
,-
......
-. .*
LONG LAKE FARM SUPPLY
Wood Bros. Equipment-FORD TRACTORS-New Idea Equipment
Tel. Long Lake 11
CUSTOMER'S
:RDER NO. 0i)......~>..,
-.-f~
>~
? t."
ADDRESS
SOL.o BY
I CASH I C.O.D. I ~.
ON ACCT.
rOSE. RETO'I PAID OUT II
QUAN.
DESCRIPTION
/ J..:l (J ,. ? 1'+ ,J-(.
J~
~;5-:t.v",.
~! . u,
~)
,tJ.
,,(" ....,
I'
PRICE
3772
ALL CL.AIMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS BILL.
No.
RECEIVED BY
NEI.SON PRESS. 1.0NG I.AKE, MINN,
. ,/
195_
AMOUNT
~
.
.. .
i,!
I~()I~IESIH eII~
HOpklm 9022 f
Exc ('>'1 C'1 In, l't nn.
Last amount in
this column is
amount owing.
+
Minnesota Binders, Mowers and Rakes . Welding Gas and Supplies - Sporting Goods
Acme Quality Paints and Varnishes . Duo-Therm Oil Heaters
HOPKINS, MINN.
'";1"' A -: .,.,' 11 ~,,~ '1 ',J "l Q r-::L1,
.. . >0.#,.'11 .J.i. '-''*'-~. "'., _'. oJ _ '~'... t.....' ..
SoLD TO
ADDRESS
tr'JVl:l;?hi) of 2:xo::':~'i OT
P.o.
DATE
DE~RIPTlON
CHARGES
CREDITS
,~ F,) r\/ L,:, ~i:' "_:.
,
,,' ...,-
~.....~: '.J
"
Purchase order No.
D 475
Dare-J/d/ ~</
of Excelsior
Excelsior, Minn.
AMOUNT
Signe::~~J::::~~~~.................................................................
Title........................................................................
This purchase order must be attached to verified form and sent to the
Town Clerk before payment can be made.
E 1. M" e#~ ~#-
'. :xce Slor, Inn.,
Town of_ /,_ _/~I'''A. .
;;-~~~~~~~.. .
iff :?~~;,;[d--fP;iJ~..
~tate of J]mtnne~ota,
~o1tJn of <!ttJantJa~~tn
lss.
I,
19.cr
rf7t:,
~"'~7i'j; ~ tJ'-
being duly sworn,
do depose and say that the annexed bill is just and true; that property, goods, merchandise, labor or service
therein charged were actually delivered or rendered to the Town of Chanhassen, and of the value charged,
and that no part of the same has yet been paid.
Subscribed and sworn to before me this
day of
19_
Town Clerk
Dr.
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rjE"i'~~-:"':c~:_~'-'~GA'~--=-"'l.-"'- ACCOUN-I" NUj'O'lEiL.:n '\
i T-12 2-10 I 40300-5-2-1 I
'-i.-:=-.~::,:-[jil~GT-~-G:VTi-:-- r<..,\/.,i, DEf'!'I, i Nl::~T BILL "r-CODE-i
i 443 13.00 OM:
___~._._._..__._ A R
MD
______..___ TOTAl..
_ADCf,:S~,_:
NORTHERN STArES POWER COMPANY
2XCE:,s'!OR, Mit'4NESO;A
Excelsior Township
SPEC!l'l MAR 7 '54
GROSS BiLL I I NET BII..I.. I
13.00
()
.._ __._.__~..__._MD
i"
PLEASE RETURN THIS STUB
WITH YOUR PAYMENT
AR
TOTAL
CODE
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"'~OS3NNIIN 'l::IOIS'30X3
'\N\ldWO:> H3MOd 53l.\ll.5 NH3Hl.HON
STATE OF$~p~ }
tOONTY ~F .'j~/Y7/Ml ~ . 55 .
~ I:~?%.. /' ":(~..'. ...,~.-I.~",.2tfl..~.be;n.duIYSWOm,do_ond"'Yfhol
. .// V __:. P ::/"U +-
I am.. t:.. .........~. k.~~.......... .of NORTHERN STATES POWER COMPANY,
that the attached bill amounting to $. . 1. .~ : . ~ . . . . . is just and true, that the;property, goods, merchandise, labor or service therein charged,
. (0 _ (}..I // .
was actually delivered or rendered to. ?a.~ . .~r:Y.t/.L.-~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
and of the value charged and that no part of the same has as yet been paid.
Subscribed a..oo ~m. 1M,. . .1. . . . . . . . . )
daYOf...~4h//...........14~
~~~:!":;~.~~ /.'!.'~ ~ .~~;.... ~
FORM t~E.140 Notary Public, Hennepin CountY. 1959-
MY Ccmm\ssion Expires Mar. 7,
Signed:
J;~'~'~";?~/:l'~
;l::pcL?~Z<.R i/"1-'r~j L-,--~.
,::'/ - .
Town of Excelsior
liar 6
1953
Mara5
June 25
State of Minnesota
To Walter,S. Booth & Son, Dr.
716 Second Ave. South, MINNEAPOLIS 2, MINN.
By w. D. KendriCk
Clark
6 off 6
12 9A
., X2
...
12 13
12 16
.45
.70
1.50
.25
.45
3.35
.80
f;.20
10.35
~
she
Is
a~ent of
The undersigned states that
WALTER S. BOOTH & SON
the claimant; and I declare under the penalties of law that this account, claim- or demand is just and'torrect and that
no part of it has been paid.
(Signature of Claimant)
The effect of this verUlcation shall be the Bame aa if subscribed and 1IW0m to under oath.
VERIFIED BILL
No. ..................................................., 19............
CLAIM OF
Walter S. 800t& & Son
.4.ndited and aZlowed at $.................................
this..................day of.............................., 19............
Paid in Order No.......................................................
Dated............................................................., 19............
Received Order X o. ...................................................
in payment of the within account.
.................................................................., 19............
Received $................................................in full
pa.yment of the within account.
Filed in m.y office this....................................
day of........................................................., 19_..........
III Mi:et:nka State Bank Agenc;VOICE
"By The Waters Of Minneton~a"
j
j
EXCELSIOR, MINN.
Date 9 March 1954
To
township of Excelsior
UIf it's insurance, we write it"
R. J. HENNESSY-Agents-I. O. KRAGNESS
I ~XPIRATIO};
II
II POLICY N;f.IBER
ii
II
Ii 2798)10
.1 2798316
il 2798336
'.
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i 3-9-56
Excelsior. Rimaesola.
II COMPANY r-.. prWPEr:TY com~D. ...TIN~~~A';ic~M~u~T
Ir .. .']===.===.~~C=~=~===cCt .1
IlllA.~T A &s j Y. lladle7 XeD<lrieIE ' .....d
'II ausell Jean Gray .Bond
il i I. A. PeUerson Bond
"! II
i 'i
il !I
jl ,I :1
JOt XUSf , Km~BY PRIICIPj
500.00
500.00
II SOO.OOI
II il
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: II
I II
Remarks Order Given by
~.:::: - -~--- -=~-~--- .~-~;-;-::::..-~-_:
Be B R.N. co. FTO. IN U.S.A.
Mortg~lgee
Order Given to
.~- ---~-'---"--"-~-~-~----
- ----------------"-~ ---_..._--,._~----_...,,- - - -,--.--,--.--.,..-
"c\
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RATE
PREMIUM DlJE
9.25
9.25
9.25
27.75
..J
PRESCRIPTIONS
~
"By the Waters of Minnetonka"
v. ~ J3acon :brug Compang
. . . THE REXALL STORE. . .
TOILETRIES
FOUNTAIN SERVICE
ji:XCELSIOR. MINN..
c__~.~~
1 L.?~'>"'---'
,L_ (,C.<.
ALL BILLS DUE 10TH OF. MONTH FOLLOWING PURCHASE
, -~\~
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<'
5)
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CZk~LV ,
....c.._ -J
2- S- '-+-
Member of Credit Bureau of Lake Minnetonl<lt
lli_
~hmt ~nnepin ([1lU~ ~e1ief ~llarb
120 NINTH AVENUE SOUTH
~uphinlll, JQllinncllIubl:
Received $ 42.18 for Hennepin County Welfare Board
reimbursement for DuCharme Account.
. !EII.I~u:PI~~ COUNty REl'E~ BOARD
SUBURBAN f. A:".' 'A'VENUE SOUTH
13TE.NrH N
. CpK,INih MIN-
-__Ii
EMPLOYER'S QUARTERLY FEDERAL TAX RETURN
1. Federal Income Tax Withheld From Wages (If not required to withhold, write "None") . '1$ ~ ~l-
2. Adjustment for preceding quarter(s) of calendar year. (Attach explanation. See instructions) . . $
3. Income tax withheld, as adjusted. (For foutth quarter or final return, fill in Schedule C) . Enter Adjusted Total Here~ $
Federal Insurance Contributions Act Taxes (If no taxable wages paid, write "None") g
4. Number of employees listed in Schedule A ___...____m__' 5. Total taxable wages paid (from Item 21) . $ -
6. 4% of wages in Item 5 (2% employer tax and 2% employee tax) . . . . . . . . . . . . $ -
7. Credit or adjustment. (Attach explanation. See instructions) . . . . . . $
8. F.I.C.A. taxes, as adjusted. . . . . . . . . . . . .. ... Enter Adjusted Total He~ $
9. Total taxes (Item 3 plus Item 8). If deposits of taxes are made, fill in Schedule B . . ., .... . $
FORM 941 (RIY. Jan. 1154)
U. S. Treasury Department
Internal Revenue Service
DUPLICATE
__ to e retained by texpllyer
,.-
Jo~
JO~
Return for Calendar Quarter
(Enter quarter as shown on original)
IMPORTANT
Keep this copy at your principal
place of business, together with a
copy of each related schedule or
statement.
Before filing the return be sure to
enter on this copy your name, ad-
dress, and identifimtlOn number, and
period for which the return is filed.
p
10. Type or print in this space employer's identification number,. name, and address
exactly as shown on original
Schedule A-QUARTERLY REPORT OF WAGES TAXABLE UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT
List for each employee the WAGES taxable under the Federal Insurance Contributions Act which were paid during the quarter. If you pay an
employee more than $3,600 in a calendar year, report ONLY THE FIRST $3,600 of stich wages in Schedule A. If wages were not taxable under
the FJ.C.A., make no entries below except in Items 15 and 16. See instructions on back of original.
Sale or transfer of business.-If a business is sold or transferred by one employer to another, each employer
must file a separate return. Such a transfer occurs, for example, if a sole proprietor forms a partnership or a
corporation. Neither employer should report wages paid by the other employer. If the new employer does
not have an identification number, he should not use the identification number assigned to the previous employer,
but must file an application on Form SS-4 for a new number for himself. (See Items 15 and 16 below.)
12. Total pages of this
return, including
this page and any
pages of Form 941 a ____________
13. Total number of
employees listed
(same as Item 4) ____________
14. Number of persons
employed during
pay period end.
IU~ nearest 15th of
thIrd month in
quarter except agri.
cultural and house-
hold employees . . ____________
15. If there has been a change of ownership or other transfer of the business during the quarter, give the name of the present owner (individual,
partnership, or corporation) and the date the change took place ______ ...__.___.____.__.__._________.._____mm_wh__.___..____________________m___.__..n...
16. Do you expect to pay taxable wages in the future to any employee (other than a household employee)? Yes D No D
If "No," write "Final Return" at the top of this page, check appropriate block, and furnish the information requested below.
o Sale of business to successor 0 Formed partnership 0 Discharged all employees, but still in business
o Business discontinued 0 Formed corporation 0 Other (specify) ___n....__..mnm.n.______n.nn_..___mmm._.___.._
Date of final payment of taxable wages to any employee (other than a household employee) ....._..mm...m__________n._n.....n..n____________...__.
Records will be kept by .. _. _,.. _ _ n_ _ _...... _... n. __.........00 '00'_ _'_ _ _ _ ___ _ __. _ __... _ _ _ n'_" _ _.... _" _ _.. ........ ....... ..... ....-.... - -....... '00'
0000'" -........-... ...
at _. _... _ _ _ _ _. _ _ _ _ _'" _. _.. _.... ._... ...... 00" __,. .......... n........, _.. ... ..00............. _..... '_00'_" _.. _. .00.."" ...... ......_....... 00..... ...-.......
.... ..............
Do you expect to pay taxable wages to a household employee within the next 6 months? Yes 0 No 0
000
0000
WAGES TAXABLE UNDER F.I.C.A.
Paid to Employee in Quarter
(Before deductions)
(19)
Dollars
State, Possession, or
Territory of Employment
(or "Outside U. S.")
(20)
EMPLOYEE'S ACCOUNT NUMBER
(If number is unknown, see Circular E or A)
(17)
00
NAME OF EMPLOYEE
(Please type or print)
(18)
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--..,.....: ----_.:.....----
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If there is not enough space to list all employees above. use Schedule A continuation sheets, Form 941a.
Total w:j.ges reported in column 19 on this page
21. TOTAL WAGES TAXABLE UNDER FJ.C.A., PAID DURING QUARTER
(Total of column 19 of this page and of any continuation shem)
..... ........,-,.~~...~
$.".".........,.....""........'''. { fi~r 5th;tx,~~~1 in
,-"'- . . -,~ , .. .' ". . ...-'.,' ..
.7-1&-69832-1
t
,
Schedule B-DEPOSITARY RECEIPT RECORD
To be used only by employers who make deposits of Income tax withheld
an!llor taxes under the Federal Insurance Contributions Act .
Every employer who is liable
for more than $100 of these taxes
during a month should deposit
such taxes in a Federal Reserve
bank or an authorized local bank
in accordance with Circular E.
Such deposits for the third month
of any quarter, and deposits of
$100 or less, are permissible but
not required. Each deposit should
be accompanied by a Receipt Form
450 which will be validated by
the Federal Reserve bank and reo
turned to the employer. Validated
receipts should be listed in this
space and submitted with this
return, together with such other
remittances as may be necessary
to pay total taxes shown in Item 9
on other side of this form.
Serial No. of
Form 450
Amount
n. ._..n..n....._.. $_ ..__ __00. ._.. .._. _00_ _.
--'"---------.....--..--- -..- --/1' --~-~ ~-----..-..- ."..'
Total of all depositary receipts .
Total of other remittances (such as cash, check, M. 0., etc.)
Total payments (same as Item 9 on other side)
$__00_00 _ ..._.n__ _ _ _00_.
$
$
Schedule C-RECONCILlATION OF INCOME TAX WITHHEI,.D
(see Schedule C Instructions on back of original)
1. Total number of withholding
tax statements (Forms W-2)
transmitted herewith. . . . . . . . . .
2. Total income tax withheld from
wages during the year as shown
by withholding tax statements
(Forms W:-2) . . . . . .. . . . .. .. $ (A)
3. Total income tax withheld from wages during the year as
shown in Item 3 of Forms 941:
Quarter ended March 31. . . . .. $._..____.....___.___..______.__.__.
Quarter ended June 30. . . . . . .. .___________..___.._______________..
Quarter ended September 30. .. ...__...___........______.......___.
Quarter ended December 31. . .
Total. .. .. ...... .. .. ... $ (B)
A copy of each Form W-2 should be
retained for your records.
Any discrepancy between the amounts
shown on lines (A) and (B) must be
fully explained in an attached statement.
GENERAL INSTRUCTIONS
The instructions below relate to the preparing and filing of Form 941.
Additional instructions are contained in Circular E or Circular A. Special
instructions for employers of agricultural and household employees also
appear on the back of the original of this return.
Circular E relates to (a) income tax withholding from wages, (b)
taxes under the Federal Insurance Contributions Act (for old.age and
survivors insurance), and (c) the Federal unemployment tax on em-
ployers of eight or more employees. Circular A is available for use by
employers who have only agricultural employees and who are liable only
for F.I.C.A. taxes. Employers should refer to such circulars for informa.
tion as to the employers and employees who are liable for these taxes, the
types of payments defined by law as "wages," the computing and deducting
of taxes from wages, how to adjust errors, and other facts employers need
to know in order to comply with the law.
Circular E or Circular A may be obtained from the District Director
of Internal Revenue upon request. Employers also may obtain Circular H,
"Household Employer's Social Security Tax Guide."
Purpose of Form 941.-This form combines the reporting of income
tax withheld from wages and the taxes under the Federal Insurance Con-
tributions Act. If you have only one of these taxes to report, you should
fill in only the portions which are applicable to you.
Who must tile.-If you have one or more employees you must make a
return for the first quarter in which you are required to withhold income
tax from wages, or in which you pay wages taxable under the Federal
Insurance Contributions Act, and for each quarter thereafter.
If you temporarily discontinue paying wages (for example, seasonal
activities), you must nevertheless file returns. If the ownership of a
business changes or is transferred, both the old and the new employer
must file returns, but neither should report wages paid by the other.
After you have once filed a return, the District Director will mail you a
Form 941 every three months. If the form should fail to reach you,
request a Form 941 so that you can make your return on time.
Quarterly returns and due dates.-A return must be filed for each
quarter of the calendar year as follows:
Quarter covered Due on or before
January, February, March April 30
April, May, June July 31
July, August, September October 31
October, November, December January 31
However, if, and only if, the return is accompanied by depositary receipts,
Form 450, showing timely deposits in full payment of the taxes due for
the entire calendar quarter, the return may be filed on or before the tenth
day of the second month following the quarter.
Unless already shown on the form received from the District Director,
enter in the spaces at the right of the employer's name the months and
year of the calendar quarter for which the return is filed.
If you no longer expect to pay wages subject to any of the taxes on this
form you must file a "Final Return." Such return is due not later than
the 30th day after the date of the last payment of taxable wages as shown
in the statement called for in Item 16 of the return.
Where to tile.-The original of this form is to be sent to the United
States District Director of Internal Revenue for the district in which the
employer's principal place of business is located, or, if the employer has
no principal place of business in an internal revenue district of the United
States, with the District Director of Internal Revenue, Baltimore 2, Md.
Payment of tax.-Each return should be accompanied by remittance
(cash, check, money order, depositary receipt, or combination of these)
for the total taxes reported in Item 9.
Employer's identification number, name, and address.~Forms 941
preaddressed by District Directors should be used in filing returns. If a
preaddressed form is lost, request another. If a non-preaddressed form
must be used, type or print in Items 10 and 11 the employer's identifica.
tion number and name exactly as shown on his previous returns. Do
not use the identification number assigned to a prior owner.
An employer who is liable for F.I.C.A. taxes and who has not applied
for an identification number should file with the District Director an
application on Form SS--4. Such form may be obtained from the District
Director or from any Social Security Administration field office. An
employer who is liable for income tax withheld from wageS, but who is
not liable for F.I.C.A. taxes, will be assigned an identification number
by the District Director without application. An employer having only
household employees need not file an application for an identification
number.
Penalties and interest.-Avoid penalties and interest by making timely
returns and payments of tax. The law provides a penalty of from 5%
to 25 % of the tax, but not less than $5, for late filing unless reasonable
cause is shown for the delay. If you are unavoidably late in filing a
return, send a full explanation in writing with your return.
Penalties also are imposed by law for willful failure to pay, collect, or
truthfully account for and pay over tax, furnish statements to employees,
keep records, make returns, or for false or fraudulent returns.
Item 2. Adjustment of income tax withheld.-Item 2 should be used
for the correction of errors made in connection with the withholding of
income tax from wages paid in the preceding quarters of the same cal.
endar year. (Consult the District Director before correcting a prior.
year error.) Any amount in Item 2 must be explained by a statement
attached to the return. This statement must set forth:
(a) Explanation of the error which the entry is intended to correct;
(b) The particular return period or periods to which the error relates;
( c) The amount chargeable to each such period; and
(d) The manner in which the employer and employee have settled any
overcollection or undercoIlection of income tax withheld.
Item 7. Credit or adjustment of taxes under Federal Insurance Con-
tributions Act.-Entries in Item 7 should be made for the correction of
underpayments or overpayments of F.I.C.A. tax as reported on a prior
return, or credits for overpayments of penalty or interest paid with respect
to such tax for prior periods. If there are both an underpayment and an
overpayment to be reported, only the difference between the two should
be entered in Item 7. Any amount entered in Item 7 must be explained
by a statement attached to the return. This statement must set forth:
(a) Explanation of the error which the entry is intended to correct;
(b) The particular return period or periods to which the error relates;
( c) The amount chargeable to each such period;
(d) The tax-return period in which the error was ascertained;
(e) The fact that the employer repaid F.I.C.A. tax overcoIlected from
an employee, if the entry corrects an overcollection of tax so
repaid; and
(f) If the entry corrects F.I.C.A. tax overcollected from;ln employee in
a prior year, the fact that the employer has obtained from the
employee a written statement that the employee has not claimed
and will not claim refund or credit of the amount of such over-
collection.
If erroneous amounts of wages were reported for employees on prior
returns, include in the statement, or on a Form 941c:
(a) The name and account number of each employee whose wages
were erroneously reported;
(b) The amount of wages, if any, erroneously reported for each quarter
for each employee (if none, so state); and
(c) The amount of wages, if any, which should have been reported for
each quarter for each employee (if none, so state).
Forms 941c, if desired, may be obtained from the District DireCtor~
(See al$O the Instruct",n. on the back of the ori.l.... of this form)
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