Agenda - Council - 03/22/1983 - Laserfiche WebLink

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'" 1.e.2. III rd J.7".1.tl2) fon INSURANCE DIVISION USE ONLY RL'ccivrod PO"nla'~t'd EXAMINED AND APluoVl-d Not App,o...rd NUfl1bt."r of OUillifil:d Olficrn Chcchd by Entefed by " STATE OF MINNESOTA OEPARTMENT OF COMMERCE 5TH FLOOR METRO SOUARE BUILOING ST. PAUL, MN 55101 CERTIFICATION OF PEACE OFFICERS (Application to Participate in State Aid Apportionment for the Police Service) FOR THE CALENOAR YEAR ENOING DECEMBER 31, 19.8L. HIS CERTIFICATE MUST BE RETURNED ON OR BEFORE MARCH 1, ANNUALLY Citv of" amsey N.lI me of MunjcipalitylCo~nty 15153 Nowthen Blvd. NW, Ramsey, Minnesota 55303 Anoka Address Zip Code County. INSTRUCTIONS IF-,PACE PROVIDED IS INADEQUATE, AITACH SEPARATE SCHEDULE. PLEASE TYPE OR PRINT IN INK AND BE AC URATE. 1. On or before March 1, annually, the clerk of each municipality and the audilor of each country desiring to participate in the State - -,o.;d Apportionment and employing one or more 'peace officer(s) shaJl certify the number of fuJl time active peace officers who ~,l,Iere employed by the municipality or county for a minimum of six months as of the preceding December 31. to. the Commissioner of Insurance, State of Minnesota, Department of Commerce, Fifth Floor Metro Square Building, Seventh & Robert . Streets, St. Paul, Minnesota 55101, on this form. Municipalities shaJl also certify to the county auditor of the county wherein the municipality is located. Two copies of this certificate may be filed with the Commissioner of Insurance and one copy will be sent ~ ,to your cour~ty auditor. 2. _ If this certificate is not filed wilh the Commissioner of Insurance within the lime prescribed, the municipality or county shall be jeemed to have relinquished its rights for the year to the State Aid. Failure to receive the certification form cannot be used as a )efense for not filing. BE SURE ALL INFORMATION REPORTED IS COMPLETE AND ACCURATE. 3. _ Municipal Clerk must complete heading on page 1 (Name & Address); Section I, Interrogatories I a, b & c; 2a, b & c; 3a, b & c; iign and date on page 3. Be sure to list peace officers claimed for State Aid on page 2. . 4. County Auditor must complete heading on page I (Name & Address); Interrog,tories la, b & c; 2a, b & c; 3b; sign and date on _ page 3. Be sure to list peace officers claimed for State Aid on page 2. 5.. Municipal/County'Treasurer must complete Section 2, Page 4. Report .ill. receipts and disbursements for the police or sheriffs department. -' 6. If Interrogatory does not apply, indicate by UNA". All information requested is for the year in which application is being made. "'Police Or Peace Officer Defined. Police or Peace Officer for State Aid purposes means any person:. :1) \\1105e primary source of income derived from wages is from direct employment by a municipality or county as a law enforcement officer on a futI time basis of not less than thirty hours per week; -(2) Who has been employed (by [he applicant) for a minimum of six months prior to December 31, preceding the date of the current certification pursuant to M.S. Section 69.011. Subdivision 2, Clause b; (3) :4) (5) \\'ho is sworn to enforce the oeneral criminal laws of the State and local ordinances; I;> ,. . . -.~ Who is a licensed peace officer pursuant [0 M.S. 9 626,84. Subdivision I, (c) (except Stale Patrol or D.N,R. officers); 'Vh~ is a member of 310cal pulice relief association or lhe Public Employees Police and Fjr~ Fund; eM 0038-0.3 -I. c;?h /