Equipment Loan Monthly Reporting Form
DC-EQ.LOAN REPORT-9
(Revised 8/04) DO NOT WRITE IN THIS SPACE
LOAN NO. _____________________ Ck. No. _________Amt. $ _________
Date ___________________________
Signature _______________________
NOTE: Each loan must be reported separately, with check __________________________________
to cover each loan. All appropriate sections must be completed. Acknowledged ___________________
Receipt No. _____________________
________________________COUNTY CONSERVATION DISTRICT’S
TREASURER’S MONTHLY REPORT FOR
_____________________, 20_____
EQUIPMENT: (List all that is being amortized as a unit)
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
1. Original amount of loan to your District………………………………………….…_______________
2. Amortization payments prior to this report (line 4 previous report)…………………______________
3. Amortization payment with this report (line 13 back page)…………………………_______________
4. Total amortization payments to date (line 2 plus line 3)……………………………._______________
5. Balance due Division of Conservation (line 1 minus line 4)………………………..._______________
6. Total accumulated hours equipment has worked to date……………………………_______________
7. Hour Meter Reading at end of work month…………………………………………_______________
8. Interest paid prior to this report (line 10 previous report)………………………….._______________
9. Interest paid with this report (line 14 back page)…………………………………..________________
10. Total Interest paid to date (line 8 plus line 9)………………………………………________________
11. Total payment this month (Interest, line 9 plus – Amortization, line 3)……………_______________
Signed ______________________ Treasurer or Clerk
___________________County Conservation District
Mailing address: _____________________________
___________________________________________
Please submit one copy to the office of the Division of Conservation, 375 Versailles Road, Frankfort, Kentucky by the 10th of each month. If corrections are necessary, a copy will be sent to you with corrections marked. If you agree, please adjust to these corrections when making the next month’s report. Make checks payable to KENTUCKY STATE TREASURER.
Receipts for ___________________________, 20____
|Person for Whom Work Performed |Date |Type of Work |Amt. Comple. |Prod. Hours|Rate |
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|12. TOTAL | | | | | |
13. Amortization payment: _________________ X _________________ ………………____________
Productive Hours Rate of Amortization Per Hours
14. Interest: _______________________________ Divided by 600 = …………………...____________
Bal. Due (line 5 of Previous Report) 2% Interest 1 Month
15. Explanation of Major Repairs or Downtime: _____________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
16. Insurance Premium__________________________________________________________________
17. District Fee: __________________ hours @ _________________________ = __________________
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