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Applicatioii for Exemptioii fro�Y� Audit <br />For the year ended December 31, 2002 <br />(Fiscal year ended) <br />, <br />[;ntit��: Town of Hillrose <br />Address: 315B Emereo S r <br />Hillrose, CO 80733 <br />'I'elephune: � 970 ) 847-3761 Ye�r [,ast Audited: 1993 <br />The Locat Government Audit Law, Section 29-1-G04, C.R,S., re uires local governt�ients to nieet tl�e <br />following criteria in order to be considered for approval for exemption from audit require�iients by tlie <br />Office of tl�e State Auditor. <br />Revenues or Expenditures <br />Less lhan $1 U0,000 <br />More than $ I UU,�UO but less <br />than $300,U00 <br />More than $300,QOU <br />ns possessin sufilcien <br />ident means�otneone � <br />Exempt from Audit? Who completes exemption form? <br />Yes *Persoti skilled in gover»meiit�l <br />accountin� <br />Yes **lndenendent accountant with <br />knowledge of goven�mental <br />accounting requirements <br />No <br />udit is required <br />Not Appiicable <br />if ¢oventmentai aceounting to complete the exemption form. <br />e from the entity. <br />Certification of Preparer <br />I certif'y that 1 meet the requirements above to complete this Application for Exemption from Audit and <br />that the infonnation in this Application is complete and accurate to the best of my knowledge. <br />Name: ,��e C�•nasPl i nir <br />Title: . s ��„„���� <br />Firm Name: Joanne Gosselink <br />Firm Address: 29382 Co. Rd. R, Brush CO 80723 <br />Date Prepared: 3/29/03 Phone Number; ( 970 ) 842-0669 <br />SIGNATURE: �. ���. _ . .. e`._ _ G � , <br />7'he Audlt Law requlres that a person independent of the entity complete the Application if re��enues or <br />expenditures are more than $100,000 but less th�n $300,000. Please descrlbe �vhut 3�our relationship is <br />with the entity. _ Independent accountant. <br />Application i��r Cxemptian frdm Audit - Revised 11/U2 <br />B-5 <br />