Non-Resident Card Program

Report Form

 

 

1. For the fiscal year beginning July 1, 2011 - June 30, 2012, (Insert Name of Library Here)

 

_____ will participate in the non-resident card program

 

_____ will NOT participate in the non-resident card program

 

 

2. Name of Person completing this form: ________________________

 

3. Date the Library Board Approved: ________________________

 

4. The fee formula for the non-resident card will be

 

 

        a) General Mathematical Formula in the amount of $_________

 

 

         b) Tax Bill Method

          Property owner tax rate ________ (as reported on Per Capita Grant)

          Renter ____ percent of monthly rent.

  

        c) Average non-resident Fee in the System Area

 

          The amount  $___________

 

5. Application to the State Library for use of System Area Average was made         Yes _____ No ____

 

Application has been approved  Yes _____  No _____

 

 

Return to RPLS, ATT: Louise Greene by June 16, 2011