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CE FORM Municipal Name Municipal Code Collection for the Period form (Month/Year) Date Submitted to (Month/Year) PLEASE FILL IN THE AMOUNTS DUE TO THE STATE TREASURER IN THE TABLE BELOW: LINE FINES, FEES AND FILING FEE/ASSESSMENT DUE STATE TREASURER % CODE LINE A A Public Defender Application Fee - $40 Per Application 100% B Body Piercing 100% 17-3-30 44-32-120 Marriage License Fee - Additional $ 20 Per License Bond Estreatment 100% 20-1-3 75 C 25% 17-15-260 D DA Municip.

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