Form E-3 Annual Survey of Government Employment - Special Distric

OMB No. 0607-0452: Approval Expires 01/31/2005

E-3
U.S. DEPARTMENT OF COMMERCE

Economics and Statistics Administration
U.S. CENSUS BUREAU

FORM

E-3

(2-4-2004)

ANNUAL SURVEY OF GOVERNMENT EMPLOYMENT
MARCH 2004 - SPECIAL DISTRICTS AND LOCAL AGENCIES

RETURN TO:

U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
In correspondence pertaining
to this report, please refer to
the Census File Number above
your address
Please check here
if your address has
changed.
(Please correct any errors in name, address, and ZIP Code)

INTERNET RESPONSE: If you prefer, you may respond
to this survey via the Internet at the following web
address: http://harvester.census.gov/sge/index.html
You will only need your User ID to access the Internet form.
DATA SUPPLIED BY

User ID
a

Name
Title

Area Code and Phone Number
-

Fax

Extension
-

E-Mail
-

-

PAID EMPLOYEES/OFFICIALS

Please complete this survey form if your agency currently has paid employees/officials.
If your agency has NO PAID employees/officials, mark (x) here ¥ and check the appropriate box below:
This agency MAY have paid employees/officials in the future.
This agency IS NOT LIKELY to have any paid employees/officials in the future.
PART I - FULL-TIME STANDARD WEEKLY HOURS
What is the average or standard
number of weekly hours of work for
the MAJORITY of your full-time
employees?

Mark (X) ONE box only.
A
B

39 hours or more
37.5 to 38.9 hours

C
D

34 to 37.4 hours
32 to 33.9 hours

E

30 to 31.9 hours

Less than 30 hours per week should be reported as Part-Time.
Continue on page 2

USCENSUSBUREAU

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FORM E-3 (2-4-2004)

PART II - PAY INTERVAL

How frequently are
employees paid for
their services?
Provide the payroll
amount in Part III for
the pay period you
indicate here.

1. Full-time employees (all or most)

2. Part-time employees (all or most)

Mark (X) ONE box only
M
T
B
W

Monthly
Twice a month
Bi-Weekly
Weekly

Q
S
A

Mark (X) ONE box only

Quarterly
Semi-Annually
Annually

M
T
B
W

Monthly
Twice a month
Bi-Weekly
Weekly

Q
S
A

Quarterly
Semi-Annually
Annually

PART III - EMPLOYEES, PAYROLL, AND PART-TIME HOURS
Report data for the ONE PAY PERIOD, which includes March 12, 2004 and corresponds to the pay interval marked in Part II.

If some employees are on a different pay interval from the majority, please report these employees, their payroll, and
any part-time hours separately as indicated in the special instructions.
Part-time Employees

Full-time Employees

Type of Employee
Report full-time employees in column (a) and their payroll
in column (b) for the pay interval indicated in Part II.
Report part-time employees in column (c) and their payroll
in column (d) for the pay interval indicated in Part II.
Report in column (e) the total hours paid for all part-time
employees in column (c) during the pay interval. If actual
hours paid are not available, enter an estimate.

Number of
Employees

Gross payroll
for employees
in column (a)
(omit cents)

Number of
Employees

(a)

(b)

(c)

Total paid parttime hours for
Gross payroll
amounts
reported
for employees
in column (d)
in column (c)
(Estimate if
(omit cents)

unknown)

(d)

(e)

Additional remarks - Please indicate below any groups of your employees for which you could not supply
information or any difficulties you encountered in completing the form.

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E-3(I) (2-4-2004)

Page 1

DEFINITIONS
EMPLOYEES – Persons paid for personal services
performed in the indicated pay period, including persons
in a paid leave status. Include any officials paid on a
salary basis; by fees or commissions; on a per meeting
basis; or a flat sum quarterly, semiannually, or annually.
Exclude employees on unpaid leave, unpaid officials,
pensioners, and contractors and their employees.
FULL-TIME EMPLOYEES – Persons employed during
the pay period to work the number of hours per week
that represents regular full-time employment. Include
temporary or seasonal employees who are working the
number of hours that represents full-time employment.
PART-TIME EMPLOYEES – Persons employed on a
part-time basis during the designated pay period.
Include those daily or hourly employees usually
engaged for less than the regular full-time workweek, as
well as any part-time paid officials. Exclude here, and
report as full-time, any temporary or seasonal employees
working on a full-time basis during this pay period.

PAYROLL (GROSS BEFORE DEDUCTIONS) –
Salaries, wages, fees, or commissions earned by
employees during (or applicable to) the pay period(s)
which includes March 12, 2004. Include overtime,
premium, night differential pay, bonuses, and incentive
payments that are paid at regular pay intervals. Include
amounts withheld for taxes, employee contributions to
retirement systems, etc. Exclude lump sum payments
and the value of living quarters and subsistence
allowances furnished to employees. If some employees
are on a different pay interval from the majority, please
report these employees, their payroll, and part-time
hours separately as indicated in the Special
Instructions for Part III.
PART-TIME HOURS PAID – Total hours actually paid
during the pay interval for all persons working less than
the number of hours that represents full-time
employment. Include an estimate of hours worked
during the pay interval for part-time employees not
compensated on an hourly basis.

GENERAL INSTRUCTIONS
1. Indicate in Part I the standard weekly hours of work for most full-time employees.
2. Indicate in Part II the length or frequency of your pay interval.
3. Include all current employees whether paid from the general fund or special funds.
4. Report in Part III gross payroll amounts for just the one pay period which includes March 12, 2004.
a. Do not report cumulative salaries since the beginning of the calendar or fiscal year.
b. Do not report payroll amounts from last fiscal year.
c. Do not report the employer costs of non-wage employee benefits such as workers’ compensation,
FICA, health insurance, etc.
5. Include total paid hours of work for part-time employees in Part III, column (e). If actual hours are not
known, please enter an estimate.
6. Use the reporting format shown in SPECIAL INSTRUCTIONS FOR PART III if you have multiple pay
intervals.

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E-3(I) (2-4-2004)

Page 2

7. If you are unable to supply any of the information requested in Part III, please list in “Additional
remarks” the source(s) of the missing information (including address and telephone number).
8. If exact figures are not available, enter estimates and mark with an asterisk.
9. Complete the “Data supplied by” box on the front of the form and return the completed questionnaire
in the envelope provided.
10. Retain a copy of the completed questionnaire for your records.

SPECIAL INSTRUCTIONS FOR PART III
For example, if your government has three (3) full-time
employees and three (3) part-time employees and each
is paid at different pay intervals, report data separately
as shown in the following example:

Report separately in Part III all employees, payrolls, and
part-time hours that are on a pay interval different from
the one reported in Part II, PAY INTERVAL. Write a pay
interval code M, T, B, W, Q, S, or A next to payroll
amounts and part-time hours to indicate applicable pay
interval.

Part III

EMPLOYEES, PAYROLL, AND PART-TIME HOURS

Full-time employees
Number

Payroll
1
1
1

$3,500 (M)
$550 (W)
$20,000 (A)

Part-time employees
Number

Payroll
1
2

$1,100 (B)
$10,500 (Q)

Hours
114 (B)
1,000 (Q)

In this example, $3,500 represents the monthly (code M) amount for 1 full-time employee; $550
represents the weekly (code W) amount for 1 full-time employee; and $20,000 represents the
annual (code A) amount for 1 full-time employee; and $1,100 represents the biweekly (code B)
amount for 1 part-time employee. $10,500 represents the quarterly (code Q) amount for 2 parttime employees.

NOTE: Please note that this is a national form that applies to governments with wide differences in the size of their service areas, the
amount of the population served, and the extent and complexity of their activities. Public reporting burden for this collection of
information is estimated to vary from 10 minutes to 1 ½ hours per response, with an average of 45 minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it
displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: Paperwork Project 0607-0452, Room 3110, Federal Building 3, U.S.
Census Bureau, Washington, DC 20233-1500. You may e-mail comments to Paperwork@census.gov; use Paperwork Project 06070452 as the subject.