Form F-5 Survey of State Tax Collections

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

2014 ANNUAL
SURVEY OF STATE GOVERNMENT TAX COLLECTIONS

FORM

F-5

(03-27-2014)

OMB No. 0607-0585: Approval Expires 07/31/2017

DUE DATE:

RETURN TO:
U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001

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GENERAL INSTRUCTIONS
Before filling out this form, please read carefully each part and all related definitions and instructions.
Note especially:
1.

Report figures for the system’s fiscal year which ended between October 1, 2013 and September 30, 2014.

2.

Do not delay reporting to await finally audited figures, if substantially accurate figures can be supplied on a
preliminary basis.

3.

Report any changes in tax laws or administration which materially affected tax yields within the fiscal year
(i.e., tax repeal, new taxes, major changes in rates, bases, exemptions, or collection timing) in 4 REMARKS.

4.

Use a black or blue ballpoint pen. Do not use pencil or felt-tip pen.

1

Is the addressee title/department and mailing address the same as shown in the address label?
Mark "X" only one box.
Yes – Go to 2

No – Enter correct information below

Addressee Title or Department

Street 1

17054016

§2&I1¤

ATTN:

Street 2

City

State

Zip Code

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Page 2
PART 1 – ENDING DATE OF FISCAL YEAR
2

Which one of the following indicates the ending date of the system’s fiscal year that ended
between October 1, 2013 and September 30, 2014? Use this fiscal year even though a more recent
one may be available. Mark "X" only one box.
2013

2014

October

January

April

July

November

February

May

August

December

March

June

September

PART 2 – RECEIPTS$Bil.
3

What was the amount of tax collections for this government during the fiscal year indicated in 2 ?
Include
• Aggregates for each tax source comprising amounts received by all funds and agencies of this State
government
• Amounts of protested taxes which have been transferred to revenue accounts because of legal or
administrative determination
• Collections of delinquent taxes and applicable penalties and interest
• Taxes imposed and received by this State government which are subsequently distributed to local
governments
Exclude
• Protested taxes paid into suspense funds
• Locally collected and retained amounts of State imposed taxes
• Amounts representing discounts or commissions allowed taxpayers
• Amounts retained by local government or local officials representing tax collection costs or fees
• Amounts representing transfers between funds (except for protested taxes in revenue accounts) or amounts
collected in a prior fiscal year
$Bil.

A. Property taxes – All taxes on property, real or
personal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mil.

Thou.

Dol.

T01

Form F-5

1. General sales and gross receipts taxes . . . . . . . . . . . .

T09

2. Alcoholic beverage sales tax . . . . . . . . . . . . . . . . . . . .

T10

3. Amusement sales tax. . . . . . . . . . . . . . . . . . . . . . . . . .

T11

4. Insurance premiums sales tax . . . . . . . . . . . . . . . . . . .

T12

5. Motor fuels sales tax. . . . . . . . . . . . . . . . . . . . . . . . . .

T13

6. Parimutuels tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

T14

7. Public utilities sales tax . . . . . . . . . . . . . . . . . . . . . . . .

T15

8. Tobacco products tax . . . . . . . . . . . . . . . . . . . . . . . . .

T16

9. Other sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

T19

17054024

§2&I9¤

B. Sales taxes

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Page 3

C. Licensing and permit taxes – (e.g., Licensing and permit fees exacted (either for revenue raising or for
regulation) as a condition to the exercise of a business or nonbusiness privilege.)
$Bil.

1. Alcoholic beverages licensing and permit taxes . . . . .

T20

2. Amusements licensing and permit taxes . . . . . . . . . . .

T21

3. Corporation in general licensing and permit taxes . . .

T22

4. Hunting and fishing licensing and permit taxes. . . . . .

T23

5. Motor vehicles licensing and permit taxes . . . . . . . . .

T24

6. Motor vehicles operators licensing and permit
taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

T25

7. Public utilities licensing and permit taxes . . . . . . . . . .

T27

8. Occupation and business licensing and permit
taxes (not reported above) . . . . . . . . . . . . . . . . . . . . .

T28

9. Other licensing and permit taxes. . . . . . . . . . . . . . . . .

T29

Mil.

Thou.

Dol.

D. Income taxes

Form F-5

T40

2. Corporation net income tax. . . . . . . . . . . . . . . . . . . . .

T41

Other taxes
1. Death and gift taxes . . . . . . . . . . . . . . . . . . . . . . . . . .

T50

2. Documentary and stock transfer tax . . . . . . . . . . . . . .

T51

3. Severance tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

T53

4. Other taxes – Specify:

▼

17054032

§2&IA¤

E.

1. Individual income taxes. . . . . . . . . . . . . . . . . . . . . . . .

......

T99

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Page 4

4

Use this space for any explanations that may be essential in understanding the reported data.
Include
• Any significant changes occurring within the last year
• Any changes in tax laws or administration which materially affected tax yields within the fiscal year
• Any difficulties encountered in completing this form

Who should be contacted to answer questions about data reported on this form?
Name of contact person - Please print

§2&II¤

Area code and phone number

Email Address - Please print

Title of contact person - Please print

Extension

Area code and fax number

Date form was completed
(MM)
(DD)
(YYYY)

Thank you for completing this form.
Retain a copy of the completed questionnaire for your records.
NOTE: The U.S. Census Bureau receives its authorization to conduct this survey from Title 13, United States Code, Section 182. This form has been approved by the Office of
Management and Budget (OMB) and given the number 0607-0112. Please note the number displayed 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, under the Paperwork Reduction Act, we could not request your participation in this
voluntary survey. Information provided on this questionnaire compiled from or customarily provided in public records are exempt from confidential treatment as cited in Title 13,
United States Code, Section 9.
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 population served, and the extent and
complexity of their activities. Public reporting burden for this collection of information is estimated to vary from 1.5 hours to 10 hours per response, with an average of 3.5 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 0607-0112, U.S. Census Bureau, 4600 Silver Hill Road, AMSD-3K138, Washington, DC 20233. You may e-mail comments to Paperwork@census.gov; use Paperwork Project
0607-0112 as the subject.

Form F-5

17054040

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