VNPB DR487V Certified
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VOTE RECORD FOR FINAL ADOPTION
DR-487V
R. 6/10
OF MILLAGE LEVY
Rule 12D-16.002
Section 200.065 (5), Florida Statutes
Florida Administrative Code
Effective 11/12
Counties, municipalities, independent special districts, water management districts, MSTUs, and dependent special districts must use
this form to certify the vote of the governing body on the millage rate adopted at their final hearing. The Department will use this
form to determine compliance with the maximum millage levy provisions.
Year :County :
2017PALM BEACH
Principal Authority :Taxing Authority :
North Palm BeachNorth Palm Beach
Please list ALL members of the taxing authority governing body and their vote on the resolution or ordinance stating the millage rate
to be levied and adopted at their final hearing (s. 200.065(2)(d), F.S.). Depending on the size of the governing body, all lines may not
be needed.
Not Present or
Yes No
Name
Not Voting
1.
4
Darryl C. Aubrey
2.
4
Robert A. Gebbia
3.
4
Mark Mullinix
4.
4
David B. Norris
5.
4
Susan Bickel
6.
7.
8.
9.
10.
Attach additional sheets, if necessary. FINAL VOTE TOTALS :
500
I certify the millages and rates are correct to the best of my knowledge. The millages comply
Taxing Authority Certification
with the provisions of s. 200.065 and the provisions of either s. 200.071 or s. 200.081, F.S.
S
Signature of Chief Administrative Officer :Date :
I
Electronically Certified by Taxing Authority9/29/2017 9:58 AM
G
Contact Name and Contact Title:
Title :
N
SAMIA JANJUA, FINANCE DIRECTOR
ANDREW LUKASIK, VILLAGE MANAGER
H
Mailing Address :Physical Address
E
501 US HIGHWAY ONE
R
501 US HIGHWAY ONE
E
City, State, ZipPhone Number :Fax Number :
NORTH PALM BEACH, FLORIDA 33408
56184133605618489698
This form must be submitted to the Department of Revenue with DR-487, Certification of Compliance,
and DR-420MM, Maximum Millage Levy Calculation Final Disclosure.
All TRIM forms for taxing authorities are available on our web site at
http://dor.myflorida.com/dor/property/trim