SINGLE MEMBER DISTRICT COMMISSIONERS AND OFFICERS · Norma Chaplain Vince Micone David Jolliffe ......

* * * DUPONT CIRCLEADVISORY NEIGHBORHOOD COMMISSION (ANC 2B)Government of the District of Columbia

______________

9 Dupont CircleWashington, D.C. 20036Phone: 202-296-7333 www.DupontCircleANC.net

Report of Financial Activity

ANC 2B — Dupont Circle

3Q2001

April! May! June 2001

SINGLE MEMBER DISTRICT COMMISSIONERS AND OFFICERS

2B01 2B02 2B03 2B04 2B06 2B06 2B07Norma Chaplain Vince Micone David Jolliffe Jeff Hopp Doug Damron Marilyn Newton Irv Morgan

Chair Treasurer Secretary Vice Chair

ANC QUARTERLY REPORT OF FINANCIAL ACTIVITY

QUARTERLY REPORT PERIOD COVERED: 3Q 2001 April, May, June 2001 ANC 2B

SUMMARY OF QUARTERLY RECEIPTS AND DISBURSEMENTS: Checking Account

Balance Forward: (from “Ending Balance” of Previous Quarterly Report) $ 23,796.06

Receipts:

District Allotment(s) $ 3,663.11Interest Income 0Other Deposits 400.00Transfer(s) from Savings Account 0

Total Receipts 4,063.11

Total Funds Available $27,859.17

Disbursements:

1. Net Salaries & Wages $ 1,370.302. Workers Compensation 03. Insurance — A. Health 0

B. Casualty/Property 1,180.004. Total Federal Wage Taxes Paid 246.235. DC or State Income Taxes Paid 40.406. Unemployment Taxes Paid 07. Tax Penalties Paid 08. Local Transportation 14.009. Office Rent 010. Telephone Service 80.7411. Postage and Delivery 27.2012. Utilities 013. Printing and Duplication 014. Purchase of Service 42.3015. OfficeSupplies& Expenses 214.8216. Office Equipment—A. Rental 0

B. Purchase 017. Grants 018. Training 019. Petty Cash Reimbursement(s) 020. Transfer(s) to Savings Account 021. Bank Charges 77.0022. Other (Attach Explanation) 1,199.50

Total Disbursements 4,492.49

Ending Balance (Should Agree with Check Book Balance at End of Quarter) $ 23,366.68

Approval Date By Commission

__________________

Jeff Hopp Vince Micone Doug Damron

Treasurer Chairperson Secretary

ANC QUARTERLY REPORT CHECK LISTINGS

Check Date Payee Amount Expense PurposeNbr. Category # of Expenditure

3388338933903391 4/11/01 Meeting Space Donation3392 4/26/01 Office Mailbox3393 4/26/0 1 Address Plate (1999 P.)3394 5/01/01 ANC2BPhone33953396 5/31/01 Payroll - Executive Director3397 5/29/01 ANC2B Phone3398 5/29/01 Office Supply Reimbursement3399 6/05/01 Stamps3400 6/05/0 1 Office Supplies3401 6/05/0 1 Federal Taxes — Payroll3402 6/06/01 ANC Banners34033404340534063407340834093410 6/21/01 ANC2B Phone3411 6/21/01 Cab Fare Reimbursement3412 6/21/01 Office Supply Reimbursement3413 6/21/01 Payroll Services3414 6/21/01 DC Withholding Tax3415 6/21/0 1 Insurance for Office3416 6/21/01 Office Supply Reimbursement3417 6/29/01 Payroll - Executive Director

Outstanding on March 2001 statement, photocopy included in this report.Listed on 2Q report.Listed on 2Q report.St. Thomas Church 1,000.00 22*Home Depot 59.00 15Staples 18.99 15Verizon 23.92 10VOIDFrank Montgomery 834.70Verizon 28.61 10Jeff Hopp 17.93 15U.S.P.S. 27.20 11Staples 61.38 15internal Revenue Svc. 246.23 4TheSignShop 199.50 22*

VOIDVOIDVOIDVOIDVOIDVOIDVOiDVerizonVince MiconeFrank MontgomeryPaychexDC TreasurerInternational RisksIrv MorganFrank Montgomery

28.2114.0030.7742.3040.40

1,180.0026.75

535.60

10815145

3B15

* See attached explanation

** Check is outstanding. Front copy only available at this time. Copy of back of check will be included in 4Q 2001.

***4 . .

DUPONT CIRCLEADVISORY NEIGHBORHOOD COMMISSION (ANC 2B)Government of the District of Columbia9 Dupont CircleWashington, D.C. 20036Phone: 202-296-7333 www.DupontCircleANC.net

Date: August 7, 2001

To: DC Auditor

From: Jeff Hopp, Treasurer ANC 2B (Dupont Circle)

Re: Line 21 “Other” Disbursements

Check # 3391 to St. Thomas Church for meeting space donation. [t was not listed as a grant, but isincluded in our 2001 budget under Meeting Space.

Check # 3402 to the Sign Shop was for two ANC banners to hang at public events and at our meetingspace. The banners list our web address and our telephone number. The banners are included in our2001 budget under Communications.

2B01 2B02 2B03Norma Chaplain Vince Micone David Jolliffe

Chair


2B06Marilyn Newton

2B07Irv MorganVice Chair

2B04Jeff HoppTreasurer

2B06Doug DamronSecretary

Bank Reconciliation Forms, Copies of Checking Statementsand Copies of Checks (front and back)

ADVISORY NEIGHBORHOOD COMMISSION

QUARTERLY FINANCIAL REPORT

BANK RECONCILIATION FORM

Date: APgJL 2( Prepared By:Title:

BALANCE FROM BANK STATEMENT: I 2 ‘15? /7

Outstanding Checks:

Check # Amount

Total Amount Outstanding Checks: (subtract)

____________________

Deposits Not Yet Recorded: (add)

__________________

Other Items: (add or subtract)

___________________

BALANCE FROM CHECK BOOK: I 26 7i7


QUARTERLY FINANCIAL REPORT


Date:

________________

Prepared By:Title: e4-e-{

BALANCE FROM BANK STATEMENT: 2 37

Outstanding Checks:

Check # Amount


_________________


_______________

Other Items: (add or subtract)

________________

BALANCE FROM CHECK BOOK: 2, 3g7.26


Q QUARTERLY FINANCIAL REPORT


Date: 3LVE 2c’o/ 3/744Prepared By:Title: c21 7i—-.

BALANCE FROM BANK STATEMENT:

Outstanding Checks:

Check # Amount

3’//7 53. O

23c1o2.2



j Other Items: (add or subtract)

BALANCE FROM CHECK BOOK:

—

23, %. &,

Statement

DUPONT CIRCLE ADVISORY 2NE I GHBORHOODJEFF HOPP (TREASURER)1507 CHURCH STREET,NW.,WASHINGTON DC 20005

01—023—829 PAGE 1

STATEMENT PERIOD 04-01-2001 THROUGH 04-30-2001

____________________CHECKING

SUMMARY_____________________

OPENING BALANCE 24,263.12 ACCOUNT # 01—023—829DEPOSITS 3,663.11 # OF ENCLOSURES 2—CHECKS 1,467.06 AVERAGE BALANCE 24,248.59=NEW BALANCE 26,459.17

____________________CHECKING

ACTIVITY_____________________

DEPOSITS DATE AMOUNT DEPOSITS DATE AMOUNT

DEPOSIT 04—24 3,663.11

CHECKS DATE AMOUNT CHECKS DATE AMOUNT

3388 04—03 467.06 3391 04—18 1,000.00

_____________________CHECKING

BALANCES_____________________

03—31 24,263.12 04—18 22,796.0604—03 23,796.06 04—24 26,459.17

For General Banking and Account Information, call (301) 887-6000 or(800) 368-5800 toll-free within the Continental U.S., or visit ourwebsite at www.riggsbank.com. For inquiries on Electronic Bankingtransactions, ATM, or CheckCard, call (301) 887-6000 and press 5.

J Riggs Bank N.A Member FDIC Member Federal Reserve System.

t’R..IG-GS Statement

DUPONT CIRCLE ADVISORY 3NE I GHBORHOODJEFF HOPP (TREASURER)1507 CHURCH STREET,NW.,WASHINGTON DC 20005

01—023—829 PAGE 1


____________________CHECKING

SUMMARY_____________________

OPENING BALANCE 26,459.17 ACCOUNT # 01-023—829+DEPOSITS .00 # OF ENCLOSURES 3—CHECKS 101.91 AVERAGE BALANCE 26,360.19NEW BALANCE 26,357.26

____________________CHECKING

ACTIVITY_____________________


3392 05—01 59.00 3394 05—04 23.923393 05—02 18.99

____________________CHECKING

BALANCES___________________

04—30 26,459.17 05—02 26,381.1805—01 26,400.17 05—04 26,357.26

For General Banking and Account Information, Call (301) 887-6000 or(800) 368—5800 toll—free within the Continental U.S., or visit ourwebsite at www.riggsbank.com. For inquiries on Electronic Bankingtransactions, ATM9 or CheckCard, call (301) 887-6000 and press 5.

J Riggs Bank N.A Member FDIC Member Federdi Reser\ e Syssem

fRIGGS

DUPONT CIRCLE ADVISORYNE I GHBORHOODJEFF HOPP (TREASURER)1507 CHURCH STREET,NW.,WASHINGTON DC

Statement

20005

14

01—023—829


PAGE 1

CHECKING SUMMARY

OPENING BALANCE+DEPOSITS—CHECKS--OTHER DEBITS=NEW BALANCE

26,357.26400.00

2,777.9877.00

23,902.28

ACCOUNT ## OF ENCLOSURESAVERAGE BALANCE

01—023—82914

25,290.87

CHECKING ACTIVITY

REFERENCE DESCRIPTION

REF 01 REORDERED CHECKS DELUXE CHECK CHECK/ACC. THE DISTRICT OF CO

____________________CHECKING

BALANCES

______________

DEPOSITS DATE AMOUNT DEPOSITS DATE AMOUNT

DEPOSIT 06—14 400.00


3397 06—01 28.61 REF 01 06—19 49.503398 06—04 17.93 3416 06—25 26.753401 06—05 246.23 3410 06—25 28.213399 06—07 27.20 3413 06—25 42.303396 06—07 834.70 3414 06—27 40.403400 06—11 61.38 3411 06—28 14.003402 06—12 199.50 3412 06—28 30.77

REF 01 06—19 27.50 3415 06—28 1,180.00

05—31 26,357.26 06—07 25,202.59 06—19 25,264.7106—01 26,328.65 06—11 25,141.21 06—25 25,167.4506—04 26,310.72 06-12 24,941.71 06—27 25,127.0506—05 26,064.49 06—14 25,341.71 06—28 23,902.28

For General Banking and Account Information, call (301) 887-6000 or(800) 368-5800 toll-free within the Continental U.S., or visit ourwebsite at www.riggsbank.com. For inquiries on Electronic Bankingtransactions, ATM, or CheckCard, call (301) 887-6000 and press 5.

U Riggs Bank N.A Member FDIC Member Federal Reserve SysLem.

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29 March 2001

Dupont Circle ANC202/518-7845

Dear ANC;

St. Thomas’ Parish asks groups using the church building for a donation to assist us withthe costs of maintaining the building and providing heat, air conditioning, and otherneeded services for groups in the building.

We suggest that groups donate $30 per meeting hour. By our reckoning, the ANC holdsthe space for three hours each month, which would lead to a donation of $1 .080. Giventhe shorter usage in the summer, $1,000.00 is the suggested donation.

We look forward to hearing from you.

St. Thomas’ Parish

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ANC 2B Billing Date 4/5/01FUR DUPONT CIR(’LE Account 000055989552 91Y202 296-7333 Page 1 of 6

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1 KX-FA55 REPLACEHEN037988809127

SUBTOTAL30.77N30.77

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Visa 30.77

Card No.: XXXXXXXXXXXX6B9O <S>Expiration Date: 05/04Auth No.: 027894

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r INVOICE# 20010531 CLIENT# 0031—0991

P0 BOX 2950MERRIFIELD, VA 22116

ADDRESS SERVICE REQUESTED

0031 -0991DC GOVERNMENTDUPONT CIRCLE ANC1507 CHURCH ST NNNASH !NGTON DC 20009

TOTAL AMOUNT DUE$42.30

AMOUNT ENCLOSED

PLEASE PAY TOTAL AMOUNT DUE BY 06/11/01

PAYCHEX, INCPD BOX 2950MERRIFIELD, VA 22116—2950

III I I liii I1I Ii 11111111111 11111 I III 111111

TO ENSURE PROPER CREDIT, PLEASE WRITE YOUR CLIENT NUMBER ON YOUR CHECK AND RETURN THIS PORTION WITH YOUR PAYMENT.PLEASE NOTE ANY ADDRESS CHANGES ABOVE.

IF YOU HAVE QUESTIONS ABOUT YOUR ACCOUNT, PLEASE CALL (703) 698-6910

CLIENT # 0031-0991 DUPONT CIRCLE ADVISORYBILLING PERIOD 04/27/01 TO 05/31/01

CHARGES 04/27/01 TO 05/31/011 PAYROLL ENTRIES

SALES TAX

PAGE 1 OF 1

NVOICE DATE 05/31/01INVOICE # 20010531TERMS: NET 10 DAYS

PLEASE PAY TOTAL AMOUNT DUE BYJUNE 11, 2001

A LATE CHARGE OF $15.00 WILL BEAPPLIED IF YOUR PAYMENT IS NOTRECEIVED PRIOR TOJUNE 27. 2001.

PAYCHEX. INCP0 BOX 2950MERRIFIELD. VA 22116—2950

DATE DESCRIPTION / SERVICES

PREVIOUS BALANCE

PAYMENTS

05/31/0105/31/01

AMOUNT

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ACCOUNT SUMMARY

TOTAL PREVIOUS AMOUNT 0.00

PAYMENTS —0.00

PAST DUE AMOUNT 0.00

CURRENT CHARGES 42.30

TOTAL AMOUNT DUE 42.30

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*DISTRICT OF COLUMBIA GOVERNMENT

_______

OFFICE OF TAX AND REVENUE

______

P.O. BOX 7702, BEN FRANKLIN STATIONWASHINGTON. D.C. 20044

EMPLOYER

MONTHLY RETURNFR-900M

Official form is smaller than full page. Please cut to size along dashed lines before tiling.

TRANSACTION NUMfl[R

OFFICIAL USE ONLY DOLLARS CENTSBUSINESS TAX REGISTRATION NUMBER Month Day Year D.C. INCOMETAX,C.

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CERTIFICATION: I HEREBY CERTIFY UNDER PENALTY OF LAW, INCLUDING CRIMINAL PENALTIESFORFALSESTATENTSUDERD.C.CODEI2225I4,TTTHJSRETUTOTHEBESTOFMy OFFiCIAL IKNOWLEDGEADBELjEF,IsTJE,agJCO

USESIGNATURE TITLE DATE ONLY J

THE DISTRICT OF COLUMBIA GOVERNMENT3414DUPONT CIRCLE A.N.C. 2B

PH. 202-296-7333#9 DUPONT CIRCLE NW

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05/31/2001International RisksRayna Robinson

DISTRICT OF COLUMBIA GOVERNMENTDUPONT CIRCLE A.N.C. 28


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Copy of Updated 2001 Budget

A A A DUPONTCIRCLEADVISORYW NEIGHBORHOOD COMMISSION (ANC 2B)

____

Government of the District of Columbia#9 Dupont Circle, NWWashington, DC 20036Telephone: (202) 296-7333

2001 BUDGET

Available Funds Original Revised Revised Activity Balance2/01 Annual Actual Through Available

3rd Quarter Funds

FY 2000 Carryover 14,998 14,998 14,998 14,998.00 14,998.00FY 2001 Allotment 14,652 14,652 14,652 14,652.00 14,652.00Contributions 400 400 400.00 400.00

Total Funds Available 29,650 30,050 30,050 30,050.00 30,050.00

Expenses

ANC Security Fund 75 75 75 - 73.26 1.74Communications 1,000 100 600 - 199.50 400,50Community Recognition 500 500 500 - 0.00 500.00Equipment 1,500 300 900 - 388.97 511.03Grants 2,000 0 0 - 0.00 0.00Insurance 500 500 1,250 -1,180.00 70.00Local Transportation 500 200 300 - 52.50 247.50Legal Review 0 400 650 - 0.00 650.00Meeting Space 2,000 2,000 1,000 -1,000.00 0.00Office Supplies 1,200 600 900 - 670.55 229.45Postage and Delivery 750 750 750 - 276.70 473.30Printing and Duplication 1,000 900 1,200 - 490.67 709.33SMD Expenses 2,100 0 700 - 0.00 700.00Staff 0 8,000 5,000 -1,699.23 3,300.77Telephone Service 1,500 750 1,250 - 450.67 799,33

Total 14,625 15,075 15,075 6,482.05 8,592.9543% 57%

Unbudgeted Reserves

Total 15,025 14,975 14,975 - 0.00 14,975.00


2B01 2B02 2B03 2B04 2B06 2806 2B07Norma Chaplain Virice Micone David Jolliffe Jeff Hopp Doug Damron Marilyn Newton lrv Morgan

Chair Treasurer Secretary Vice Chair

Miscellaneous Executive Director Information

• Job Description and Employment Contract• Business Tax Registration Information• DC Employers Quarterly Contribution and Wage Report• Federal Quarterly Tax Return

EXECUTIVE DIRECTOR POSITION DESCRIPTIONDupont Circle Advisory Neighborhood Commission

Supervisor: Chairperson

Scope of Work: The Executive Director works at the pleasure of the Commission. Salary is $7,500 peryear with three weeks paid vacation. The office location is the Dupont Circle Resource Center. Theincumbent will be required to conduct local travel within the District of Columbia in the conduct of officialbusiness. Metro reimbursement will be provided, upon approval. The incumbent will work 15 hours perweek, including some evenings. Additional benefits are not offered with this position.

Duties:

• The Executive Director shall be responsible for the logistics of all public meetings of theCommission. The Executive Director shall prepare the location and all materials for publicmeetings. The Executive Director shall record and distribute, pending approval, the officialminutes of public meetings. The Executive Director shall prepare an email summary of publicmeetings for distribution within 48 hours after the meeting.

• The Executive Director shall be responsible for managing and distributing mail to the appropriateCommissioner for action. The Executive Director shall draft responses to correspondence, whenappropriate, for signature by the Chairperson or other Commissioners. The Executive Directorshall be responsible for mass mailings, fax mailings, and e-mail management. The ExecutiveDirector will forward telephone messages to the appropriate Commissioner.

• The Executive Director shall promptly file appropriate materials in the Commission’s official files,maintain the files, and recommend sending outdated materials to the DC Archives.

• The Executive Director shall track all Commission deadlines for ABC, BZA, I-IPRB, ZoningCommission, and any other administrative applications requiring official comment by theCommission. The Executive Director shall draft letters of support and protest for administrativeapplications for signature by the Chairperson. The Executive Director shall ensure that theseletters are filed in a prompt manner with the appropriate administrative agency. The ExecutiveDirector shall attend administrative hearings at the direction of the Chairperson and may, on rareoccasions, be directed to represent the Commission’s official positions when Commissioners arenot present.

• The Executive Director shall prepare the Commission’s annual report and shall maintain statisticaland other records of the Commission’s activities.

• The Executive Director shall serve as a community advocate and problem solver, contactingappropriate District officials to resolve citizen concerns at the direction of the Chairperson andother Commissioners. The Executive Director shall track and log complaints and concerns andshall follow-up with progress reports to the Commission and other interested parties.

• The Executive Director shall work with the Treasurer in maintaining the official financial recordsof the Commission and shall file all appropriate documents with the DC Auditor at theTreasurer’s direction.

• The Executive Director shall complete other duties as assigned by the Chairperson.

EMPLOYMENT CONTRACT

PARTiES: Advisory Neighborhood Commission 2B andFrank Montgomery

1. Frank Montgomery agrees to provide the services of Executive Director, as set forth in theattached position description.

2. Frank Montgomery will provide fifteen hours of service per week for the duration of thiscontract.

3, This contract may be discontinued at any point by either party.

4. Advisory Neighborhood Commission 2B will compensate Frank Montgomery a salary of$7,500 per year, $277.77 every two weeks. Advisory Neighborhood Commission 2B willpay the employer’s share of FICA and other payroll taxes.

5. Advisory Neighborhood Commission 2B will provide three weeks of paid vacation.

Vmce Micone, Chair ANC 2B

////o/Date’ /

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Montgomery

Date

* * * Government of the Disu-ict of ColumbiaOffice of the Chief Financial Officer 941 North Capitol Street, NEOffice of Tax and Revenue Washington, D.C. 20002

NOTICE OF BUSINESS TAX REGISTRATION

Date of Notice: June 13, 2001 Notice Number: 0030987010613

DISTRICT OF COLUMBIA GOVERNMENT1999 P ST NW PU BOX 33224 EIN: 52-1834528WASHINGTON, DC 200330224

I 111111 11111 11111 MIII 11111 liii 11111 11111 11111 liii 11111 11111 11111 lW liii

You have been registered for the tax(es) shown below. Your filing basis has been determined as shown. It isimportant that the Employer identification Number referenced above be used on all correspondence and returns.

TAX ACCOUNT FILING TAX YEARTYPE ID FREQUENCY END

WITHHOLDING 30000001 1284 ANNUAl. FY12

Any tax returns currently due are enclosed with this notice. Tax returns that are due in the ftiture will be mailedseparately to you prior to the due date. If you have tax returns that are delinquent, you will be notified by theOffice of Tax and Revenue.

if applicable you will also be registered for Unemployment Compensation Taxes and will be contacted by theOffice of Unemployment Compensation regarding your filing requirements. Any questions concerning yourliability for Unemployment Compensation may be answered by calling (202) 724-7457.

A Declaration of Estimated Franchise Tax (Form D-20 ES or D-30 ES) must be filed by every corporation andunincorporated business whose franchise tax may reasonably be expected to exceed $1,000 for the taxable year.

Should you have any questions please call (202) 727-4TAX (4829) or send correspondence to:

Customer Service AdministrationBusiness Tax Registration SectionP.O. Box 470Washington, DC 20044

Government of the District of Columbia Department of Emplo;ment ServicesUnemployment Tax Division • Employment Security Building • 500 C. Street, NW. • Suite sot • Washington. D.C. 20001

May30, 2001 r-)[ (-k

,——

D C GOVERNMENT DUPONT CIRCLE ANCP0 BOX 33224WASHINGTON DC 20033-0224

ACCOUNT NO. 127 994

Thank you for registering with the Unemployment InsuranceDivision. Your business is not only providing a valuable serviceto the public, it is also helping the District of Columbia’seconomy grow.

Our field representative in your area is Mary E Jackson. Shouldassistance be needed regarding Unemployment Insurance Tax relatedissues, please contact the representative for information or toschedule an appointment at (202) 724-7460.

Good luck in your new venture.

Sincerely,Frank Orlando

Associate Director, OUCOffice of Unemployment CompensationTelephone (202) 724-7274

JOB’mVtllelping People Help Themselves

DISTRICT OF COLUMBIADEPARTMENT OF EMPLOYMENT SERVICES

OFFICE OF UNEMPLOYMENT COMPENSATION500 C STREET NW ROOM 501

WASHINGTON, DC 20001

TELEPHONE (202) 724-7274 FAX (202) 724-7104

DATE: 05/29/2001

UI ACCOUNT NO. 127 994

O C GOVERNMENT DUPONT CIRCLE ANCPD BOX 33224WASHINGTON DC 20033-0224

This is your mailing address; notify us of any corrections.

RATE EFFECTIVE CONTRIBUTIONQUARTERS RATE

2001/2 - 2001/4 .027

You have been determined subject to the reporting provisions of the Districtof Columbia’s Unemployment Insurance Law. Please include your account numberon all correspondence with this agency.

Reporting forms will be sent to you at the end of each calendar quarter.These reports must be postmarked by the last day of April, July, Octoberand January of each year.

If we can be of any further assistance, please write to the above address.

APPEAL RIGHTS

This decision will become final Unless you file a written notice ofappeal within thirty (30) calendar days of the date of this letter.with the Unemployment Insurance Division of the District of Columbia.

IMPORTANT MESSAGE FOR SELF-INSURED (SI.) EMPLOYERS

TOTAL WAGES PAID TillS 0Th. 4. NOTE:(TAXABLE & NON-TAXABLE)

CHECK APPLICABLE

ITEMS BELOW

AND DESCRIBE

FULLY ON PART FIV

D ADDRESSCHANGE

D NAMECHANGE

_______________________________ D ADDITIONALBUSINESS ADDED

BUSINESS SOLD

D OUT OF BUSINESSIN D.C.

D BUSINESS INACTIVE

NO EMPLOYEESIN FUTURE

01180 0031—0991

IF YOU ARE A SELF—INSURED EMPLOYER AND “YOUR TAX RATE IS” SI., COMPLETE ITEMS 1 THRU 9 ONLY

EMPLOYERS QUARTERLY

CONTRIBUTION AND WAGE

REPORT

I” -‘ DCDOES) UC-30 (REV. 4-94)

.OYER NUMBER 5K DIGIT NO.

DEPARTMENT OF EMPLOYMENT SERVICESOFFICE OF UNEMPLOYMENT COMPENSATION

P.O BOX 96664WASHINGTON, D.C. 20090-6664

TELEPHONE 202) 724-7467

YOUR TAX BATE IS2 .000

°

FOR THE QUARTER ENDING

JUNE 30, 2001

INDUSTRY CODE

POSTMARK DATE

100 NOT USE THIS SPACE)

DUPONT CIfCLE ADVISOIY

NEIGHB0IHOOD COFIMISSION 2 B

1999 P ST NW P0 BOX 3322k

WASHINGTON DC 20033

DEPARTMENT OF FINANCE & REVENUE

BUSINESS TAX REGISTRATION NUMBER

1. EMPLOYEE WAGE INFORMATION

SOC. SECURITY ACCT. NUMBER

READ INSTRUCTIONS ON BACK OF PART ONE BEFORE COMPLETING THIS FORM

FOR THIS QUARTER

1 6. FEDERAL IDENTIFICATION NUMBER

52-1834528

A REPORT MUST BE FILED - IF YOU PAID NO WAGES WRITE “NONE” IN ITEM 7, SIGN AND RETURN.

NAME OF EMPLOYEE

07/31/01THIS REPORT DUE

SEE ATTACHED WAGE LISTING

OTHER

1 3. TOTAL WAGES

I ENTIRE REPORT

CHECK HERE IF TIPS ARE INCLUDED IN ITEM 3. ALSO SEE INSTRUCTIONS 2. TOTAL WAGES

FOR ITEM 7 ON BACK OF PART ONE FOR EXPLANATION OF ALL “WAGES”. THIS PAGE I

TOTAL NUMBER OF COVERED WORKERS EMPLOYED DURING QUARTER. MUST AGREE WITH TOTAL IWORKERS LISTED ON THIS FORM AND FORM DUCB 31, CONTINUATION SHEET, IF USED.

NUMBER OF COVERED WORKERS. FOR EACH MONTE, ENTER THE NUMBER OF COVERED 1 ST MONTH 2ND MONTH 3RD MONTH

6. WORKERS WHO WORKED DURING OR RECEIVED PAY IN THE PAYROLL PERIOD WHICH ,DO NOT USE THIS COLUM

INCLUDED THE 12TH OF THAT MONTH •1j

TOTAL WAGES PAID THIS QUARTER COMBINED TOTAL OF TAXABLE AND NON-TAXABLE $ 1666 I 6 5WAGES), MUST AGREE WITH ITEM 3 I

8. NON-TAXABLE WAGES SEE INSTRUCTIONS FOR ITEM 8 $TAXABLE WAGES SUBJECT TO CONTRIBUTIONS, $ 1 6 6 6 6 5ITEM 7 LESS ITEM B.

I

CONTRIBUTION DUE FOR THIS QUARTER. $10. MULTIPLY ITEM 9 BY TAX RATE SHOWN ABOVE 33 I

-•LESS APPROVED CREDIT MEMO $INTEREST. IF CONTRIBUTIONS ARE NOT PAID WHEN DUE, ADD 1 1/2% OF THE AMOUNT

I

12. YTEM 101 FOR EACH MONTH OR FRACTION THEREOF FROM THE DATE DUE UNTIL PAID I

13. PENALTY. SEE INSTRUCTIONS ON BACK OF PART ONE. $

14. NET PAYMENT DUE IMAKE CHECK OR MONEY ORDER PAYABLE TO “DCDOES.”I $ 33 33

15 I CERTIFY THAT THE INFORMATION CONTAINED IN THIS REPORT AND ANY WAGE REPORT(S) ATTACHED HERETO IS TRUE AND CORRECT AND

THAT NO PART OF THE TAX. WAS OR IS TO BE DEDUCTED FROM THE WORKER’S WAGES.

‘ REFERENCE COPY PREPARED BY PAYCHEX. DO NOT FILE.

SIGNATURE TITLE TELEPHONE I I DATE,,,_,,,.,..,,,_....,...,.... 19,,,,,,

CONTINUATION SHEET FOR REPORTING TO STATE

DUPONT CIRCLE ADVISORYNEIGHBORHOOD COMMISSION 2 B

P ST NW P0 BOX 33224WASHINGTON DC 20033

52—1834S280031—O991 DC

Date Quarter Ended

JUNE 30, 2001

Emniover’s identification number, name and address

Page Number Name of State

1 OF 1 DST OF COLUMBIA

ENTER ON

PAGE 1

ONLY

REFERENCE COPY PREPARED BY PAYCI-IEX. DO NOT FILE.

242-.64—2641

TAXABLE WAGES

1666.65

GRAND TOTAL ALL WAGE REPORT SHEETS

-

-

I I

EMPLOYEE’S STATE Excess WagesTOTAL WEEKS

SOCIAL SECURITY NAME OF EMPLOYEE TAXABLE Over StateWAGES’

NUMBER WAGES’ Limit J——

MONTGOMERY ,FRANK MOYLE

TOTAL WAGES EXCESS WAGES

1666.65

1666’ 65 166665I

1666TOTALS FOR THIS PAGE

NUMBER OF EMPLOYEES

AND WAGE TOTALS

________

1

r,nrnnrtm, DV OAVf’UV 1kW’

166665

• EMPLOYER: Only use columns applicable to

Form 941(Rev. January 2001)DeparimeoL of tue Treasuryirileroaf ilevenue Service

Enter statecode for statein whichdeposits weremade ONLY ifdifferent fromstate inaddress tothe right(see page2 ofinstructions).

you do not have to file returns in the future, check here and enter date final wages paid

you are a seasonal employer, see Seasonal employers on page 1 of the instructions and check here. .. .

1 Number__of__employees__in__the__pay__period__that__includes__March__1_2th 1, . 1666 65

2 Total wages and tips, plus other compensation— 11 i

3 Total income tax withheld from wages, tips, and sick pay...........

4 Adjustment of withheld income tax for preceding quarters of calendar year

5 Adjusted total of income tax withheld (line 3 as adjusted by line 4 — see instructions)

6 Taxable social security wages 6a $ 16 66 6 5 I x 12.4% (.1 24)

Taxable social security tips 60 $ DEl x 12.4% (.1 24) = 6d.

7 Taxable Medicare wages and tips 7a 1666 65 x 2.9% (.029) = ..2.L4 B

8 Total social security and Medicare taxes (add lines 6b, Gd, and 7b). Check here it wages25 99

are not subject to social security and/or Medicare tax DS Adjustment of social security and Medicare taxes (see instructions for required explanation)

— 01Sick Pay $ ±Fractioris of Cents $ —

01 Other $ = —p—10 Adjusted total of social security and Medicare taxes (line B as adjusted by line 9 — see

instructions) io 25 L)

1 1 Total taxes (add lines 5 and 10)366

12 Advance earned income credit (EIC) payments made to employees13 Net taxes (subtract line 12 from line 1 1). If $2,500 or more, this must equal line 17,

366 23column (dl below for line D of Schedule B (Form 94111

14 366 2314 Total deposits for quarter, including overpayment applied from a prior quarter — —

5 0015 Balance due (subtract line 14 from line 131. See instructions —_

16 Overpayment. If line 14 is more than line 13, enter excess here $and check if to be: LZI Applied to next return OR Refunded.

• All filers: If line 13 is less than $2,500, you need not complete line 17 or Schedule 8 (Form 94 1).

• Semiweekly schedule depositors: Complete Schedule B (Form 941) and check here

• Monthly schedule depositors: Complete line 17. columns (a( through (dl and check here

17 Monthly Summary of Federal Tax Liability. Do not complete if you were a semiweekly schedule depositor.

(a) First month liability (b) Second month liability (c) Third month liability (dl Total liability for quarter junuer penaitis at perjury, i decLare thai I have examined this returo, inciuding accnmpauylng scneuuies ano sraremenrs, and to the best ci my knowieage

S 19fl and belief, it is rue, coned, nod cnmpleie.

Here SignatureREFERENCE COPT PREPARED 51 PAYCHEX. Print Your00 NOT FItE. Name and Title Date

0031—0991 011B0

Employer’s Quarterly Federal Tax ReturnSee separate instructions for information on completing this return.

Please type or print.

DUPONT CIRCLE ADVISORYNEIGHBORHOOD COMMISSION 2 B1999 P ST NW P0 BOX 3322wWASHINGTON DC 20033

0MB No. 1545-0029

JUNE 30 2001

52—183452B

If

If

For Privacy Act and Paperwork Reduction Act Notice, see back of Payment Voucher. Form 941 (Rev. 1-20011

0031—0991 01180

SCHEDULE B(FORM 941)(Rev, November I 9981

Iteparimeol vi lIre TreasuryInlernal Revenue Service

Name as shown on Form 941 (Form 941—SS)

Attach to Form 941 or Form 941-SS

You must complete this schedule if you are required to deposit on a semiweekly schedule, or if your tax liability on any

day is $100,000 or more. Show tax (lability here, not deposits. (The IRS gets deposit data from FTD coupons or EFTPS.)

A. Daily Tax Liability—First Month of Quarter —

1 8 15 22 29

2 9 16 23 30

3 10 17 24 31

4 11 18 25

5 12 19 26 :::

6 13 20 27

7 14 21 28 :.

A Total tax_liability for first month of quarter. —

A

— B. Daily Tax Liability—Second Month of Quarter — —

1 8 15 22 29

2 9 16 23 30

3 — 10 17 24 31 46

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

S Total tax liability for second month of quarter —8 24623

C. Daily Tax Liability—Third Month of Quarter

1 8 15 :22 29 12000

2 9 16 23 30

3 10 17 24 31

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

C Total tax (lability for third month of quarter. C 12000

D Total for quarter (add lines A, B, ondCl. This should equal line 13 of Form 941 (or line 10 of Form 941SSl’ D 366 2

Schedule B (Form 941) (Rev. 11-98)

5151

Employer’s Record of Federal Tax LiabilitySee Circular E for more information about employment tax returns.

DUPONT CIlCLE ADVISOIY

0MB No. 1545—0029

Erriployer idenlificalion number

52—1834528

Dale quarrel ended

JUNE 30 2001

For Paperwork Reduction Act Notice, see page 2.

SINGLE MEMBER DISTRICT COMMISSIONERS AND OFFICERS · Norma Chaplain Vince Micone David Jolliffe ......

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