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U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
2012 Annual Survey of County, Municipal, and Township
Government Finances
U.S. CENSUS BUREAU
(8-4-2010)
FORM
F-28
(04-05-2011) Draft 1
OMB No. 0607-0585: Approval Expires 06/30/2011
In correspondence pertaining to this report, please refer to the ID printed above your address
RETURN TO:
U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
If you have any questions,
please call 1-888-590-2748
weekdays, 7:00 a.m. to
5:00 p.m. EST.
Questions can also be
emailed to:
govs.finstaff@census.gov
Please correct any errors in name, address, or ZIP Code.
INTERNET RESPONSE
You may respond to this survey via the Internet at the following web address: http://harvester.census.gov/sgfnet
You will only need your User ID to access the Internet form. Your User ID is the first 14 digits of the 18 digit ID located
on the top line of the address section above.
GENERAL INSTRUCTIONS
Before filling out this form, please read carefully each part and all related definitions and instructions.
Note especially:
1. Please report amounts covering all funds and accounts of your agency except for any employeeretirement
funds administered by your agency. Include bond redemption and interest funds, and construction or
development funds, as well as current funds. Exclude refunds and transfers between funds or accounts of
your agency.
2. As this form is used for various kinds of agencies, some of the items may not apply to your agency.
However, read carefully the definition of each item to determine whether it applies to any of your agency’s
transactions.
3. Do not delay reporting to await finally audited figures, if substantially accurate figures can be supplied on a
preliminary basis.
4. You may report on either a cash or accrual basis.
5. Use a black or blue ball point pen.
Part 1
ENDING DATE OF FISCAL YEAR
Mark (X) in the appropriate box below to indicate the ending date of your government’s fiscal year
(12 month accounting period) and report data for this period only.
Use this fiscal year even though a more recent one may be available.
2011
2012
July
October
January
April
August
November
February
May
September
December
March
June
Please continue on the next page
USCENSUSBUREAU
§,#!.¤
11020047
Part 2
TAX REVENUES
Report collections during the fiscal year indicated in Part 1 from all taxes imposed by your government.
Include current and delinquent amounts, penalties, and interest.
Exclude receipts from service charges, special assessments, interest earnings, fines, and any other sources
that are not taxes or licenses.
1. Property taxes - All taxes on property, real or personal.
Report collections during the fiscal year from all levies for
all funds of your government, and its agencies. . . . . . . . . . . . . . . . .
Tax Revenues
T01
$
,
,
.00
Include levies for debt service, pension funds, and other funds or purposes.
Exclude any taxes you collected on behalf of other governments and taxes not measured by value.
2. Local sales taxes - Taxes on goods and services, measured as a percent of sales or receipts, or as an
amount per unit sold (gallon, package, etc.)
Include only taxes imposed by your government.
Exclude shares of taxes imposed by another government (report in Part 3).
A. General sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T09
$
B. Alcoholic beverages sales tax . . . . . . . . . . . . . . . . . . . . . . . . . .
T10
$
C. Amusements sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T11
$
D. Motor fuels sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T13
$
E. Parimutuels tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T14
$
Public utilities sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T15
$
G. Tobacco products tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T16
$
T19
$
F.
H. Other sales tax, specify:
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
.00
.00
.00
.00
.00
▼
...
.00
3. Licensing and permit taxes - (e.g., license and inspection charges on occupations, businesses, animals,
vehicles, etc.)
A. Alcoholic beverages licensing and permit taxes . . . . . . . . . . . . .
T20
$
B. Amusements licensing and permit taxes . . . . . . . . . . . . . . . . . .
T21
$
C. Motor vehicles licensing and permit taxes . . . . . . . . . . . . . . . . .
T24
$
D. Public utilities licensing and permit taxes . . . . . . . . . . . . . . . . . .
T27
$
E. Occupation and business licensing and permit taxes
(not reported above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F. Other licensing and permit taxes, specify:
T28
$
T29
$
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
.00
.00
.00
▼
...
Please continue on the next page
Form F-28
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11020047
Part 2
TAX REVENUES - Continued
Tax Revenues
4. Local income taxes
A. Individual income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T40
$
B. Corporation net income tax . . . . . . . . . . . . . . . . . . . . . . . . . . .
T41
$
A. Death and gift tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T50
$
B. Documentary and stock transfer tax . . . . . . . . . . . . . . . . . . . . .
T51
$
C. Severance tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T53
$
T99
$
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
5. Other taxes
D. Other taxes, specify:
.00
.00
.00
▼
...
Please continue on the next page
Form F-28
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11020047
INTERGOVERNMENTAL REVENUES
Part 3
Report all amounts received by your government from other governments during the fiscal year
indicated in Part 1.
Include grants, shares of taxes imposed by other governments, payments in lieu of taxes, and reimbursements
for services performed for other governments. If your government received payments under the American
Recovery and Reinvestment Act of 2009 (ARRA), include them in the appropriate categories below.
Exclude loans, any taxes imposed by your government which were collected for it by another government
(reported in Part 2) and receipts from utility sales to other governments (report in Part 4).
From other local
governments
From the Federal
government directly
From the State
Include any amounts financed
wholly or in part from Federal
grants to the State (i.e., pass-throughs).
Exclude collection fees.
1. Streets and highways
D46
$
C46
1. Streets and highways.00
,
,
$
B46
,
,
.00
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
2. Education
D21
$
C21
1. Streets and highways.00
,
,
$
B21
,
,
.00
$
.00
3. Public welfare (including Medicaid)
D79
$
C79
1. Streets and highways.00
,
,
$
B79
,
,
.00
$
.00
4. Health and/or hospitals
D42
$
C42
1. Streets and highways.00
,
,
$
B42
,
,
.00
$
.00
5. Housing and community development
D50
$
C50
1. Streets and highways.00
,
,
$
B50
,
,
.00
$
.00
6. Water supply system
D91
$
C91
1. Streets and highways.00
,
,
$
B91
,
,
.00
$
.00
7. Sewerage
D80
$
C80
1. Streets and highways.00
,
,
$
B80
,
,
.00
$
Please continue on the next page
Form F-28
4
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11020047
INTERGOVERNMENTAL REVENUES - Continued
Part 3
From other local
governments
From the Federal
government directly
From the State
Include any amounts financed
wholly or in part from Federal
grants to the State (i.e., pass-throughs).
Exclude collection fees.
8. Electric power system
D92
$
C92
1. Streets and highways.00
,
,
$
B92
,
,
.00
$
,
,
,
,
,
,
,
,
.00
9. Gas supply system
D93
$
C93
1. Streets and highways.00
,
,
$
B93
,
,
.00
$
.00
10. Mass transit rail and/or bus system
D94
$
C94
1. Streets and highways.00
,
,
$
B94
,
,
.00
$
.00
11. Airports
D89
$
C89
1. Streets and highways.00
,
,
$
B01
,
,
.00
$
.00
12. Natural resources - Sale of minerals and other natural products from public lands. Include revenue
from agricultural fairs and shows.
D89
$
C89
1. Streets and highways.00
,
,
$
B59
,
,
.00
$
,
,
,
,
,
,
.00
13. General support (unrestricted)
D30
$
C30
1. Streets and highways.00
,
,
$
B30
,
,
.00
$
.00
14. All other, specify:
D89
$
C89
1. Streets and highways.00
,
,
$
B89
,
,
.00
$
Please continue on the next page
Form F-28
5
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11020047
Part 4
REVENUES - OTHER THAN TAX AND INTERGOVERNMENTAL REVENUES
Report other revenues received by your government during the fiscal year reported in Part 1.
Include revenues of all funds except those noted in any separate instructions included with this form.
Exclude refunds and transfers between funds and accounts of your government.
1. Utility sales revenues - Gross receipts of any water, electric, gas, or
transit systems operated by your government, from utility sales and charges.
Include amounts received from the sale of utility commodities and services
to the local, State, or the Federal government.
Utility Sales Revenues
A. Water supply system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A91
$
B. Electric power system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A92
$
C. Gas supply system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A93
$
D. Transit or bus system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A94
$
,
,
,
,
,
,
,
,
.00
.00
.00
.00
2. Other sales and service revenues - Gross receipts from fees, sales, rentals,
tolls, maintenance assessments, and other charges for commodities or services.
Exclude utility receipts (reported in item 1 above) and amounts received from
other governments (reported in Part 3).
Other Revenues
A. Sewerage charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A80
$
B. Refuse collection and disposal charges. . . . . . . . . . . . . . . . . . .
A81
$
C. Parks and Recreation charges. . . . . . . . . . . . . . . . . . . . . . . . .
(swimming, golf, auditoriums, etc.)
A61
$
D. Airports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Include rentals and gross sales of gas and oil.
A01
$
E. Hospital charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A36
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
.00
.00
.00
Include amounts received on behalf of individual patients under the
Medicare program or other insurance-type arrangements.
Exclude Medicaid and the amounts for hospital purposes received
from other governments (reported in Part 3).
F. Parking facilities (lots, garages, meters, etc.). . . . . . . . . . . . . . . .
A60
$
G. Housing project rentals (gross). . . . . . . . . . . . . . . . . . . . . . . . .
A50
$
(1) Operated on a fee or toll basis . . . . . . . . . . . . . . . . . . . . . .
A45
$
(2) Other street and highway charges. . . . . . . . . . . . . . . . . . . .
A44
$
.00
.00
H. Highways and other roads
Include bridges, tunnels, and ferries
Please continue on the next page
Form F-28
6
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11020047
Part 4
REVENUES - OTHER THAN TAX AND INTERGOVERNMENTAL REVENUES Continued
2. Other sales and service revenues - cont’d.
Other Revenues
A87
$
Education
(1) K-12: Gross receipts from sale of school lunches . . . . . . . . .
A09
$
(2) K-12: School tuition and transportation charges . . . . . . . . . .
A10
$
(3) K-12: Other school receipts. . . . . . . . . . . . . . . . . . . . . . . . .
A12
$
K. Miscellaneous commercial activities directly operated by
your government, such as cemeteries, cable television,
telephone utilities, rail lines, etc. . . . . . . . . . . . . . . . . . . . . . . . .
A03
$
L. Natural resources charges.- Sale of minerals and other
natural products from public lands. . . . . . . . . . . . . . . . . . . . . . .
A59
$
...
A89
$
3. Special assessments - Compulsory contributions and
reimbursements from owners of property benefited by
improvements (streets, sewers, sidewalks, water extensions,
etc.), as well as for servicing special assessment debt . . . . . . . . . . .
Exclude proceeds from sales of special assessment bonds
(report in Part 10) and maintenance assessments (reported
in item 2 above).
U01
$
4. Receipts from sale of property and other capital assets . . . . . . .
U11
$
U20
$
6. Fines and forfeits - Receipts from penalties imposed for
violations of law and civil penalties . . . . . . . . . . . . . . . . . . . . . . . . .
U30
$
7. Rents - Revenues from temporary possession or use of
government-owned buildings, land, and other properties. . . . . . . . . .
U40
$
I. Sea and inland port facilities . . . . . . . . . . . . . . . . . . . . . . . . . . .
J.
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
.00
.00
.00
.00
M. Other sales and service revenues, specify
Include miscellaneous fee collections.
▼
.00
.00
.00
Include property sold to other governments.
Exclude tax sales (reported in Part 2).
5. Interest earnings - Interest received on all deposits and
investment holdings of your government, and its agencies. . . . . . . . .
.00
Include interest on construction funds.
Exclude earnings of any employee pension fund.
Please continue on the next page
Form F-28
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11020047
Part 4
REVENUES - OTHER THAN TAX AND INTERGOVERNMENTAL REVENUES Continued
Other Revenues
8. Royalties - Compensation or portion of proceeds from
extraction of natural resources, such as oil, gas and
mineral rights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
U41
$
9. Private donations - Gifts of cash or securities from
private individuals or corporations. . . . . . . . . . . . . . . . . . . . . . . . . .
U50
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
10. Miscellaneous other revenues - Revenues of your government
and its agencies not reported in items 1 through 9, or Parts 2 - 3).
Include insurance claims, recoveries of prior year expenditures, dividends, and
recorded profits from sale of investments.
Exclude proceeds from borrowing, receipts from sale of security holdings, transfers
between funds or accounts of your government, employee contributions to, and
interest earnings of, any employee pension fund.
Specify and report miscellaneous revenue:
A.
...
U99
$
B.
...
U99
$
C.
...
U99
$
D.
...
U99
$
E.
...
U99
$
Part 5
.00
.00
.00
.00
.00
TOTAL REVENUES
Total Revenues
Sum of Parts 2 - 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . REV
$
,
,
Please continue on the next page
Form F-28
8
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11020047
Part 6
INTERGOVERNMENTAL EXPENDITURES
Report all payments made to other governments for services or programs performed on a
reimbursement or cost sharing basis.
To other local governments
1. Highways
M44
$
2. Financial administration
M23
$
3. Central administration
M29
$
4. Fire protection
M24
$
5. Parks and recreation
M61
$
6. Solid waste
management
M81
$
7. Sewerage
M80
$
8. Water supply system
M91
$
9. Hospitals
M36
$
10. Health (other than
hospitals)
M32
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
To the State
.00
L44
$
.00
L23
$
.00
L29
$
.00
L89
$
.00
L61
$
.00
L81
$
.00
L80
$
.00
L91
$
.00
L36
$
.00
L32
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
Please continue on the next page
Form F-28
9
§,#!P¤
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
11020047
Part 6
INTERGOVERNMENTAL EXPENDITURES - Continued
To other local governments
11. Police protection
M62
$
12. Judicial and legal
services
M25
$
13. Correctional Institutions
M04
$
14. Other correctional
activities
M05
$
15. Libraries
M52
$
16. Public welfare
M79
$
17. Protective inspection
M66
$
18. Housing and community
development
M50
$
M59
$
M01
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
To the State
.00
L62
$
.00
L25
$
.00
L04
$
.00
L05
$
.00
L58
$
.00
L79
$
.00
L66
$
.00
L50
$
.00
L59
$
.00
L01
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.00
.00
.00
.00
.00
.00
.00
.00
19. Natural resources flood control, soil and water
conservation, drainage
irrigation, forestry and forest
fire protection, agricultural
fairs, and any other activities
for promotion of agriculture
and conservation of natural
resources.
20. Airports
Please continue on the next page
Form F-28
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11020047
Part 6
INTERGOVERNMENTAL EXPENDITURES - Continued
To other local governments
21. Electric supply system
M92
$
22. Parking
M25
$
23. Natural gas supply
system
M93
$
24. Transit
M94
$
25. Sea and inland port
facilities
M87
$
26. Education
(elementary, secondary)
M12
$
27. Education
(post-secondary)
M18
$
28. Other, specify:
M50
$
▼
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
To the State
.00
L92
$
.00
L25
$
.00
L93
$
.00
L94
$
.00
L87
$
.00
L12
$
.00
L18
$
.00
L50
$
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
Check here if your government made no payments to other governments during the fiscal year
reported in Part 1.
Please continue on the next page
Form F-28
11
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.00
.00
.00
.00
.00
.00
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE
Part 7
Report amounts expended during the fiscal year indicated in Part 1.
Include expenditures of all funds except those noted in any separate instructions with this form.
Exclude:
• Transfer between funds or accounts of your government
• Payments made to other governments (reported in Part 6).
Current Operation
Capital Outlays
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services.
Include gross salaries and
wages before deductions.
Exclude capital outlays and
depreciation/amortization
Purchase of equipment,
land and existing structures
Include capital leases
Construction
1. Toll highways - maintenance, operation, repair, and construction of highways, roads, bridges, ferries, and
tunnels operated on a fee or toll basis.
E45
$
F45
1. Streets and highways.00
,
,
$
G45
,
,
.00
$
,
,
.00
2. Highways - Construction and maintenance of roads, sidewalks and bridges; street lighting; snow removal;
highway engineering, control, and safety.
Exclude street cleaning expenditures (report in item 7).
E44
$
F44
1. Streets and highways.00
,
,
$
G44
,
,
.00
$
,
,
.00
3. Financial administration - office of the finance director, auditor, comptroller, treasurer; tax assessment
and collection; central accounting and purchasing services, budgeting, etc.
E23
$
F23
1. Streets and highways.00
,
,
$
G23
,
,
.00
$
,
,
.00
4. Central administration - county or city council, aldermen or commissioners; county, city or town
administrator or manager; clerks office, recorder, planning, zoning and personnel.
E29
$
F29
1. Streets and highways.00
,
,
$
G29
,
,
.00
$
,
,
.00
5. Fire - firefighting and fire prevention.
Include ambulance and paramedic services handled by the fire department and contributions of volunteer
fire units.
Exclude any contributions to a local fire pension fund and forest fire protection amounts (report in item 21).
E36
$
F36
1. Streets and highways.00
,
,
$
G36
,
,
.00
$
,
,
Please continue on the next page
Form F-28
12
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11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
6. Parks and recreation - playgrounds; golf courses; swimming pools; museums; marinas; community music,
drama, festivals; zoos, and other cultural activities.
E61
$
F61
1. Streets and highways.00
,
,
$
G61
,
,
.00
$
,
,
.00
7. Solid waste management - street cleaning and the collection, recycling and disposal of refuse and garbage.
E81
$
F81
1. Streets and highways.00
,
,
$
G81
,
,
.00
$
,
,
.00
8. Sewerage - construction, maintenance and operation of sanitary and storm sewer systems and sewage
disposal plants.
E80
$
F80
1. Streets and highways.00
,
,
$
G80
,
,
.00
$
,
,
,
,
.00
9. Water supply system
E91
$
F91
1. Streets and highways.00
,
,
$
G91
,
,
.00
$
.00
10. Hospitals - construction and operation of hospitals by your government; payments to hospitals operated
privately.
E36
$
F36
1. Streets and highways.00
,
,
$
G36
,
,
.00
$
,
,
.00
11. Health (other than hospitals) - all public health activities; except provision of hospital care.
Include environmental health activities; health regulation and inspection, water and air pollution control,
mosquito control, animal control warden, inspection of food handling establishments, and ambulance and
paramedic services not part of a fire department. Also include public health nursing, vital statistics collection,
and all other services performed directly by the public health department.
Exclude payments under public welfare programs (report in item 18).
E29
$
F29
1. Streets and highways.00
,
,
$
G29
,
,
.00
$
,
,
.00
12. Police - police agencies for preventing, controlling, or reducing crime; law enforcement activities or sheriff
and constable offices; coroners; medical examiners; vehicular inspection activities; traffic control and safety
activities; lock-up operations.
Exclude your contribution to a local police pension fund; local court activities (report in item 13), and local
correction activities (report in items 14 and 15).
E29
$
F29
1. Streets and highways.00
,
,
$
G29
,
,
.00
$
,
,
Please continue on the next page
Form F-28
13
§,#!P¤
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
13. Judicial and legal - all county or municipal court and court-related activities including juries, probate
officials, prosecutors, bailiffs, marshals, public defenders, attorneys, legal departments, and court activities
of sheriffs departments.
Exclude probation and parole (report in item 15).
E25
$
F25
1. Streets and highways.00
,
,
$
G25
,
,
.00
$
,
,
.00
14. Correctional institutions - construction, maintenance, and operation of correctional facilities, reformatories,
detention facilities, etc., whether for adults or juveniles.
Exclude activities related to probation and parole (report in item 15).
E04
$
F04
1. Streets and highways.00
,
,
$
G04
,
,
.00
$
,
,
.00
15. Other corrections - activities related to probation and parole, training of corrections officers, nonresidential
halfway houses, and community corrections centers.
E05
$
F05
1. Streets and highways.00
,
,
$
G05
,
,
.00
$
,
,
.00
16. General public buildings - construction, maintenance, and operation of government office buildings not
relating to particular purposes. Report single-purpose buildings (firehouses, hospitals, etc.) at the purpose
specified.
E31
$
F31
1. Streets and highways.00
,
,
$
G31
,
,
.00
$
,
,
.00
17. Libraries - payments to nongovernmental libraries as well as expenditures for libraries operated by your
government.
E52
$
F52
1. Streets and highways.00
,
,
$
G52
,
,
.00
$
,
,
Please continue on the next page
Form F-28
14
§,#!P¤
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
18. Public welfare - support of, and assistance to, needy persons, including expenditures from State and
Federal grants.
A. Money paid directly to needy persons covered by Federal aid programs (Temporary Assistance for
Needy Families)
J67
$
1. Streets and highways.00
,
,
B. Money paid directly to needy persons not covered by Federal aid programs (general relief, home
relief, poor relief, etc.)
J68
$
1. Streets and highways.00
,
,
C. Payments to landlords, utilities, vendors, etc., for rent, goods, and services furnished to needy persons,
other than for medical and hospital care.
E75
$
1. Streets and highways.00
,
,
D. Payments to private vendors for medical and hospital care provided to needy persons. Exclude
payments to hospital or health agencies operated by your government (reported in items 10 and 11).
E74
$
1. Streets and highways .00
,
,
E. Welfare institutions operated by your government, including nursing homes, veterans’ homes, homes
for the elderly, and indigent care institutions.
E77
$
F77
1. Streets and highways .00
,
,
$
G77
,
,
.00
$
,
,
.00
F. Other public welfare - Administration of relief and assistance, foster care, related community action programs, and other welfare activities not reported in A, B, C, D and E above.
E79
$
F79
1. Streets and highways .00
,
,
$
G79
,
,
.00
$
,
,
Exclude any payments to theState for your government’s shareof the welfare costs (reported in Part 6).
Please continue on the next page
Form F-28
15
§,#!P¤
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
19. Protective inspection and regulation - regulation of private enterprise for the protection of the public and
inspection of hazardous activities (including building inspection), except when related to major functions,
such as health, natural resources, etc.
F66
E66
$
1. Streets and highways.00
,
,
$
G66
,
,
.00
$
,
,
.00
20. Housing and community development - gross expenditures for urban renewal housing projects, and
similar activities.
E50
$
F50
1. Streets and highways.00
,
,
$
G50
,
,
.00
$
,
,
.00
21. Natural resources - flood control, soil and water conservation, drainage, irrigation, forestry and forest fire
protection, agricultural fairs, and any other activities for promotion of agriculture and conservation of natural
resources.
E59
$
F59
1. Streets and highways.00
,
,
$
G59
,
,
.00
$
,
,
,
,
,
,
.00
22. Airports
E01
$
F01
1. Streets and highways .00
,
,
$
G01
,
,
.00
$
.00
23. Electric power system
E92
$
F92
1. Streets and highways .00
,
,
$
G92
,
,
.00
$
.00
24. Parking facilities - garages, parking lots, and all purchases and maintenance of meters, etc.
E60
$
F60
1. Streets and highways .00
,
,
$
G60
,
,
.00
$
,
,
,
,
,
,
.00
25. Gas supply system
E93
$
F93
1. Streets and highways .00
,
,
$
G93
,
,
.00
$
.00
26. Transit or bus system
E94
$
F94
1. Streets and highways .00
,
,
$
G94
,
,
.00
$
Please continue on the next page
Form F-28
16
§,#!P¤
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
27. Sea and inland port facilities - docks, wharves, harbors, piers, canals, waterways and related warehouses.
F87
E87
$
1. Streets and highways.00
,
,
$
G87
,
,
.00
$
,
,
.00
28. Miscellaneous commercial activities - directly operated by your government, such as cemeteries, cable
television, telephone utilities, rail lines, etc.
E03
$
F03
1. Streets and highways.00
,
,
$
G03
,
,
.00
$
,
,
.00
29. Education - if your government does not directly administer schools, report any expenditures for school
purposes. If your government does directly administer schools, please see any separate instructions for your
state.
Exclude payments to local school districts (reported in Part 6).
E12
$
F12
1. Streets and highways.00
,
,
$
G12
,
,
.00
$
,
,
30. Interest on debt - amounts of interest paid, including any interest on short-term or non-guaranteed
obligations as well as general obligations.
Include capitalized interest paid on construction loans.
A. Interest on water supply system debt
I91
$
1. Streets and highways .00
,
,
B. Interest on electric power system debt
I92
$
1. Streets and highways .00
,
,
C. Interest on gas supply system debt
I93
$
1. Streets and highways .00
,
,
D. Interest on transit or bus system debt
I94
$
1. Streets and highways .00
,
,
E. Interest on all other debt
I89
$
1. Streets and highways .00
,
,
Please continue on the next page
Form F-28
17
§,#!P¤
.00
11020047
DIRECT EXPENDITURES BY PURPOSE AND TYPE - Continued
Part 7
31. All other expenditures - any amounts which have not been allocated above by purpose.
Include:
•
•
•
•
Your employer contribution to a state administered retirement system or to the Federal Social Security
Administration
Judgements and insurance premiums
Government service agencies, such as a central garage or an IT or engineering department which serves
more than one functional agency, and whose expenses are not allocated to the various departments
Recorded losses from sale of investments
Exclude:
•
•
•
•
Payments for retirement of debt
Payments for purchase of securities
Transfers between funds or agencies of your government
Benefits and payments from self-administered employee pension funds
Current Operation
Capital Outlays
Direct expenditures including
salaries and wages
Purchase of equipment,
land and existing structures
Construction
A. Other - specify:
$
G89
F89
E89
1. Streets and highways.00
,
,
$
,
,
.00
$
,
,
,
,
,
,
,
,
,
,
,
,
.00
B. Other - specify:
$
G89
F89
E89
1. Streets and highways.00
,
,
$
,
,
.00
$
.00
C. Other - specify:
$
G89
F89
E89
1. Streets and highways.00
,
,
$
,
,
.00
$
.00
D. Other - specify:
$
G89
F89
E89
1. Streets and highways.00
,
,
$
,
,
.00
$
.00
E. Other - specify:
$
G89
F89
E89
1. Streets and highways.00
Part 8
,
,
$
,
,
.00
$
.00
TOTAL EXPENDITURES
Sum of Parts 6 - 7
. . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .
EXP
$
Please continue on the next page
Form F-28
18
§,#!P¤
.00
11020047
Part 9
PERSONNEL EXPENDITURES
Report total expenditures for salaries and wages reported in
Part 7, including any paid to employees of your government
working on construction projects . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part 10
Personnel Expenditures
Z00
$
,
,
.00
INDEBTEDNESS
Long-term Debt
Bonds, mortgages, etc., with an original term of more than one year, including revenue bonds and
special assessment bonds as well as general obligation bonds.
Include debt refunded.
Exclude
• Capital leases (reported in Part 7).
• Amounts for compensated absences
Long-term Debt
for Public Purposes
1. What is your government’s debt for all public purposes?
19U
A. Outstanding at beginning of fiscal year . . . . . . . . . . . . . . . . +
29U
B. Issued during fiscal year (include all refunding issues). . . . . . +
39U
C. Retired during fiscal year (include debt refunded) . . . . . . . . . 49U
D. Outstanding total at end of fiscal year (items 1A + 1B - 1C) . =
$
$
$
$
2. What is your agency’s debt for privately owned housing,
industrial, or business purposes? This category is applicable
only to those agencies authorized to issue debt of this type (e.g.,
industrial development revenue bonds, pollution control revenue
bonds, etc.)
,
,
,
,
,
,
,
,
.00
.00
.00
.00
Long-term Debt
for Private Purposes
19T
A.
Outstanding at beginning of fiscal year. . . . . . . . . . . . . . . . +
B.
Issued during fiscal year (include all refunding issues). . . . . . +
C.
Retired during fiscal year (include debt refunded) . . . . . . . . . -
D.
Outstanding total at end of fiscal year (items 2A + 2B - 2C). =
24T
34T
44T
$
$
$
$
,
,
,
,
,
,
,
,
.00
.00
.00
.00
Short-term (interest-bearing) Debt
Tax-anticipation notes, bond-anticipation notes, interest-bearing warrants, and other obligations with
an original term of one year or less.
Exclude accounts payable, other non-interest-bearing obligations,and current portion of long-term debt
(reported as long-term debt above).
Short-term Debt
3. Amount outstanding at beginning of fiscal year. . . . . . . . . . . . .
4. Amount outstanding at end of fiscal year. . . . . . . . . . . . . . . . . .
61V
64V
$
$
,
,
,
,
Please continue on the next page
Form F-28
19
§,#!P¤
.00
.00
11020047
Part 11
CASH AND INVESTMENTS HELD AT END OF FISCAL YEAR
Report cash and investments held at the end of the fiscal year indicated in Part 1, including:
• The total amount of cash and cash equivalents on hand and on deposit
• Investments in Federal government, Federal agency, State and local government and
non-governmental securities
Report all investments at market value.
Exclude accounts receivable, value of real property, and all non-security assets.
1. Reserves held for redemption of long-term debt (e.g.,
sinking or debt service funds) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Include any mortgages and notes receivable held as offsets
to housing and industrial financing loans
Amount at end
of fiscal year
Long-term Debt
for Public
Purposes
,
,
W01
$
.00
2. Unexpended proceeds from sale of bond issues held
pending disbursement (e.g., bond funds). . . . . . . . . . . . . . . . . . .
W31
$
Long-term Debt
for Public
Purposes
,
,
.00
3. All other cash and investments - checking/savings accounts,
CD’s, stocks, bonds, mutual funds, etc. . . . . . . . . . . . . . . . . . . . . .
W61
$
Long-term Debt
for Public
Purposes
,
,
.00
Exclude employee retirement funds.
Part 12
REMARKS
Part 13
CERTIFICATION
This report is substantially accurate and has been prepared in accordance with the instructions.
Name of person completing report - Please print
Title of person completing report - Please print
Date form was completed
Telephone Number
Area Code
Number
E-mail Address - Please print
Ext.
Thank you for your report. Please return to:
U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
This form has been approved by the Office of Management and Budget (OMB) and has been given the number 0607-0585. Please note
that we have displayed this number in the upper right hand corner of this form. Display of this number confirms that we have approval
from OMB to conduct this survey. If this number was not displayed, we could not request your participation in this survey.
Please note that this is a national form that applies to governments with wide differences in size of their service areas, the amount of
population served, and the extent and complexity of their financial accounts. We estimate public reporting burden for this collection of
information to vary from 3.0 to 40.0 hours per response, with an average of 6.0 hours 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.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to: Paperwork Project 0607-0585, U.S. Census Bureau, 4600 Silver Hill Road, AMSD-3K138, Washington, D.C. 20233. You may
e-mail comments to Paperwork@census.gov; use "Paperwork Project 0607-0585" as the subject.
Census Use Only
BEG
REV
EXP
REP
DIFF
V98
Form F-32
20
END
§,#!P¤
| File Type | application/pdf |
| File Title | f28_p01_12.g |
| File Modified | 2011-04-05 |
| File Created | 2011-04-05 |