Data Collection Form for Reporting on
AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS
RETURN TO: Federal Audit Clearinghouse, 1201 E. 10th Street, Jeffersonville, IN 47132
Form SF-SAC(3-20-2001)OMB #0348-0057EIN : 753061667  
Part I: GENERAL INFORMATION
1. Fiscal year ending date for this submission (mm/dd/yyyy)
6/30/2003
2.Type of A-133 audit
Single audit
3. Audit period covered
Annual
CENSUS
USE
ONLY
4.Date received by clearinghouse
5.Employer Identification Number (EIN)
a.Auditee EIN       753061667
b.Are multiple EINS covered in this report?
No
6.AUDITEE INFORMATION 7.AUDITOR INFORMATION
a.Auditee name
LEECH LAKE TRIBAL COLLEGE
b.Auditee address (Number and street)
PO BOX 180
City
CASS LAKE
State
MN
Zip Code
56633 -
c.Auditee contact
Name
VICKI RADTKE
Title
CONTROLLER
d.Auditee contact telephone
( 218 ) 335 - 4200
e.Auditee contact FAX (Optional)
( ) -
f.Auditee contact E-mail (Optional)
a.Auditor name
JOSEPH EVE
b.Auditor address (Number and street)
401 N. 31ST ST. SUITE 1600
City
BILLINGS
State
MT
Zip Code
59101 -
c.Auditor contact
Name
TIFFANY MADDEN
Title
PARTNER
d.Auditor contact telephone
( 406 ) 252 - 3535
e.Auditor contact FAX (Optional)
( 406 ) 252 - 1764
f.Auditor contact E-mail (Optional)
TIFFANY.MADDEN@JOSEPHEVE.COM
g.AUDITEE CERTIFICATION STATEMENT -This is to certify that, to the best of my knowledge and belief, the auditee has:(1)Engaged an auditor to perform an audit in accordance with the provisions of OMB Circular A-133 for the period described in Part I, items 1 and 3; (2)the auditor has completed such audit and presented a signed audit report which states that the audit was conducted in accordance with the provisions of the Circular; and,(3)the information included in Parts I,II,and III of this data collection form is accurate and complete.I declare that the foregoing is true and correct.
 
Signature of certifying official Date
Name/Title of certifying official
LEAH J CARPENTER INTERIM PRESIDENT 7/23/2004
g.AUDITOR STATEMENT - The data elements and information included in this form are limited to those prescribed by OMB Circular A-133.The information included in Parts II and III of the form, except for Part III, Items 8, 9, and 10, was transferred from the auditor's report(s) for the period described in Part I, Items 1 and 3, and is not a substitute for such reports. The auditor has not performed any auditing procedures since the date of the auditor's report(s). A copy of the reporting package required by OMB Circular A-133,which includes the complete auditor's report(s), is available in its entirety from the auditee at the address provided in Part I of this form. As required by OMB Circular A-133, the information in Parts II and III of this form was entered in this form by the auditor based on information included in the reporting package. The auditor has not performed any additional auditing procedures in connection with the completion of this form.
 
Signature of certifying official Date
8/25/2004
FAC DETERMINED TYPE OF ENTITY:   Indian Tribe/Alaskan Native Village-Dependent Institution of Higher Learning
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