F-11 Annual Survey of Public Pension Plans (Locally Administe

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
WORKSHEET

F-11

2017 CENSUS OF GOVERNMENTS
SURVEY OF PUBLIC PENSION PLANS
Locally-Administered Defined Benefit Plans

(06-05-2017) Draft 2

OMB No. 0607-0585: Approval Expires xx/xx/xxxx

WORKSHEET
DO NOT use this worksheet to respond to the survey. It is intended to assist you
with gathering and preparing your data prior to reporting online.
Return to https://respond.census.gov/aspp when you are ready to report online.

Need help or have
questions?
• Visit
https://census.gov/govs/
retire/qa_retire.html
• Call
1-800-832-2839 weekdays,
8AM to 5PM ET

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DUE DATE:

In correspondence pertaining
to this report, please refer to
the User ID supplied in your
letter.

REPORT ONLINE: It’s fast and secure. Respond
to this survey via the Internet at the following Web
address using the supplied User ID and Password:
https://respond.census.gov/aspp

GENERAL INSTRUCTIONS
Before filling out this survey, please read carefully each part and all related definitions and instructions.
Note especially:
To complete this worksheet, you will need the Comprehensive Annual Financial Report (CAFR) for the retirement
system listed in the mailing address (Use the annual report if the retirement system does not have a CAFR).

2.

Report figures for Defined Benefit plans only. Do not include Defined Contribution or other Postemployment
Benefit plans in the data.

3.

If you are including data for any retirement system(s) administered in addition to the system identified in
the address box above, list retirement system(s) in 24 , REMARKS section, at the end of the worksheet.

4.

Report corporate stocks and bonds at market value, and adhere to Governmental Accounting Standards Board
(GASB) guidelines when reporting gains and losses on investments.

5.

Report figures relating to all accounts and reserves of the system, including amounts for retirement, disability,
survivors’, and other benefits, as well as any amounts for administration of the system. Exclude transfers between
reserves of the system.

6.

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

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1.

Page 2

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1

Is the addressee title/department and mailing address the same as shown in your letter?
Yes – Go to 2

No – Enter correct information below

Addressee Title or Department
ATTN:
Street 1

Street 2

City

State

Zip Code

PART 1 – PLAN INFORMATION FOR DEFINED BENEFIT PLANS
2

Are new employees covered under this defined benefit plan?
Yes

3

In addition to the defined benefit plan reported on this survey, does this public retirement system
offer a defined contribution plan?
Yes

4

No

No

In addition to the defined benefit plan reported on this survey, does this public retirement system
offer a postemployment healthcare plan?
Yes

No

PART 2 – ENDING DATE OF FISCAL YEAR

(MM)

What is the retirement system’s fiscal year end date?. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

What was the retirement system’s latest fiscal year end date that
occurred before July 1, 2017? Use this fiscal year data to complete
the remainder of this worksheet even though more recent data may be
available. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Worksheet F-11

(MM)

(DD)

(YYYY)

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5

(DD)

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PART 3 – MEMBERSHIP AND BENEFITS FOR DEFINED BENEFIT PLANS

What was the total number of contributing members of the retirement system during the fiscal year
indicated in 6 ?
Exclude
• Beneficiaries
A. Active members – Current contributors in contributory systems or employees
in non-contributory systems.
1. Employed by the local government(s)

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Number of
Members

Include
• Local agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Employed by the state government
Include
• State institutions and agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. TOTAL – (Sum of items A1. through A2.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. Inactive members – Former employees and employees on military or other
extended leave without pay having retained retirement credits, but not currently
receiving retirement benefit payments.

Number of
Members

1. Vested . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Non-vested (on military or other extended leave only) . . . . . . . . . . . . . . . . . . . . . .

8

What was the total number of retirees and beneficiaries during the fiscal year indicated in 6 ?
Provide estimates if detailed data are not available.
Number of
Retirees/
Beneficiaries
A. Retirees of system, retired on account of age or service . . . . . . . . . . . . . . . . . . .

B. Retirees of system, retired on account of disability. . . . . . . . . . . . . . . . . . . . . . .

C. Survivors of deceased retirees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Worksheet F-11

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3. TOTAL – (Sum of items B1. through B2.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 4

What were the total number of payees and the amount of lump-sum payments made during the fiscal
year indicated in 6 ?
Number of
Amount Paid
Payees
A. Withdrawals and other
$Bil.
Mil.
Thou.
Dol.
one time payments made
to members of a deferred
retirement option plan
(DROP) . . . . . . . . . . . . . . . . . .

DBP
010

B. Withdrawals and other one
time payments (other than
loans) made to present or
former members of system
Exclude
• Payments to DROP
members (should be
reported in item A.) . . . . . . .

C. Lump-sum (nonrecurrent)

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payments made to survivors
of deceased active members
or retirees . . . . . . . . . . . . . . .

PART 4 – RECEIPTS FOR DEFINED BENEFIT PLANS
10

What was the amount of receipts during the fiscal year indicated in 6 ?
Exclude
• Amounts received from sales of investments
• Amounts received from repayment of loans made to members
$Bil.

Employee Contributions
Mil.
Thou.
Dol.

A. Employee contributions – Amounts contributed by all
member employees or withheld from their salaries for
financing benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. Employer (government) contributions
1. From parent local government(s)
Employer (Government)
Contributions
Mil.
Thou.
Dol.

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Include
• Employer contributions from the government for
financing of benefits
$Bil.
• Parent government contributions or appropriations
for administration or other support of the system
• Local taxes credited directly to the system . . . . . . . . . . .
2. From state government
Include
• State aid
• Shared taxes received by the system from the state
government either directly or through the parent
local government
• Amounts received from other local governments on
behalf of their employees . . . . . . . . . . . . . . . . . . . . . . . .

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Worksheet F-11

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Include
• Interest
• Dividends
• Rents
• Other earnings on investments
Exclude
• Gains and losses on investment transactions
(should be reported in 11 )
$Bil.

Investment Earnings
Thou.
Mil.

$Bil.

Mil.

Dol.

1. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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C. Earnings on investments

2. Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Other investment earnings – Specify:C
.....

4. TOTAL – (Sum of items C1. through C3.) . . . . . . . . . . . . . . .

D. Other receipts
Include
• Private gifts
• Donations
Specify:

11

Other Receipts
Thou.

Dol.

....

Gains and Losses
$Bil.

Mil.

Thou.

Dol.

A. Realized net gains or losses on investments . . . . . .
B. Unrealized net gains or losses on
investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

C. TOTAL – (Sum of items A. through B.). . . . . . . . . . . . . .

Worksheet F-11

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What was the amount of net gains and losses on investments during the fiscal year indicated in 6 ?
Report losses as a negative value (see HOW TO REPORT DOLLAR FIGURES on page 3).

Page 6
PART 5 – PAYMENTS FOR DEFINED BENEFIT PLANS
What was the amount of payments during the fiscal year indicated in 6 ?
Exclude
• Amounts paid out for purchase of investments and loans made to members
• Deferred retirement option plan (DROP) payments (should be reported in 9 )
$Bil.

Mil.

Payments
Thou.

Dol.

A. Benefit payments – Report annual amounts.
1. Retirement benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Disability benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Survivor benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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4. Other benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. TOTAL – (Sum of items A1. through A4.) . . . . . . . . . . . . . . .
B. Withdrawals – Amounts paid to employees, former
employees, or their survivors, representing return of
contributions made by employees during the period of
their employment, and any interest on such amounts. . . . . . . . .
C. Administrative expenses
Include
• Investment fees
• Other administrative expenses . . . . . . . . . . . . . . . . . . . . . . .
D. Other payments – Specify:C
....
PART 6 – CASH AND INVESTMENTS FOR DEFINED BENEFIT PLANS
13

Exclude
• Receivables and securities lending collateral

$Bil.

Cash and Short-term
Investments
Mil.
Thou.

Dol.

A. Cash and short-term investments
1. Cash on hand and demand deposits . . . . . . . . . . . . .

2. Time or savings deposits . . . . . . . . . . . . . . . . . . . . . .
3. All other short-term investments
Include
• Repurchase agreements
• Commercial company paper
• Finance company paper
• Bankers acceptances
• Money market mutual funds. . . . . . . . . . . . . . . . . .

4. TOTAL – (Sum of items A1. through A3.) . . . . . . . . .
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Worksheet F-11

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What was the total amount of cash and investments (at market value) held at the end of the fiscal
year indicated in 6 ?

Page 7

$Bil.

Federal Government Securities
Mil.
Thou.
Dol.

Include
• Short-term notes . . . . . . . . . . . . . . . . . . . . . . . . .
2. Federal agency
a. Securities – Bonds and mortgage-backed
securities (where applicable) issued by
CCC, Export-Import Bank, FHA, GNMA,
Postal Service, and TVA
Exclude
• Directly held mortgages (should be
reported in item F.) . . . . . . . . . . . . . . . . . . . . .
b. Federally-sponsored agencies – Bonds
and mortgage-backed securities (where
applicable) issued by FHLB, FHLMC,
FNMA, and Farm credit banks

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B. Federal government securities
1. Federal treasury securities – Obligations of the
U.S. Treasury and Federal Financing Bank

Exclude
• SLM Corporation (should be reported
in item C.) . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. TOTAL – (Sum of items B1. through B2b.) . . . . . . . .
C. Corporate bonds, domestic
Include
• Debentures and convertible bonds
• Railroad equipment certificates
• Asset-backed securities
• Commercial mortgage-backed securities
• Corporate collateralized mortgage-backed
securities
• Private debt
• SLM Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$Bil.

Corporate Bonds
Mil.
Thou.

Dol.

$Bil.

Corporate Stocks
Mil.
Thou.

Dol.

$Bil.

Foreign and
International Securities
Mil.
Thou.

Dol.

D. Corporate stocks, domestic

Exclude
• Money market mutual funds (should be
reported in item A3.)
• Other mutual funds (should be reported
in item H4.)
• Hedge funds (should be reported in item H4.) . . . . .
E.

Foreign and international securities
Include
• Foreign governments
1. Foreign and international stocks. . . . . . . . . . . . . . . . .

2. Foreign and international bonds. . . . . . . . . . . . . . . . .

3. TOTAL – (Sum of items E1. through E2.) . . . . . . . . . .
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Worksheet F-11

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Include
• Common and preferred stocks
• Warrants
• Private equity
• Venture capital
• Leveraged buy-outs

Page 8

Mortgages held directly
Exclude
• Mortgage-backed securities (should be reported
in item B2a. or C.)
• Directly held real property (should be reported
in item H1.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$Bil.

Mortgages Held Directly
Mil.
Thou.

Dol.

$Bil.

Other Securities
Mil.
Thou.

Dol.

$Bil.

Other Investments
Mil.
Thou.

Dol.

$Bil.

Cash and Investments
Mil.
Thou.

Dol.

G. Investments held in trust by other agencies
Include
• Funds administered by private agencies
• Guaranteed investment accounts
• Share of funds in governmental investment
accounts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H. Other investments
1. Real property – Report only directly held property.
Exclude
• Property held in investment trusts (should be
reported in item H3.)
• Property held in pooled or partnership
agreements (should be reported in item H3.) . . .

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F.

2. State and local government securities . . . . . . . . . . . .
3. Other investments
Include
• Property held in pooled or partnership agreements
• Property held in investment trusts
• Investments in real estate investment trusts (REITs)
Specify:

....

4. Other securities

Exclude
• Money market mutual funds (should be reported
in item A3.)
Specify:

....

5. TOTAL – (Sum of items H1. through H4.) . . . . . . . . .

I.

TOTAL – (Sum of totals for items A. through H.) . . . . . .

Worksheet F-11

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Include
• Shares held in conditional sales contracts
• Direct loans and loans to members
• Derivatives
• Guaranteed investment contracts
• Annuities and life insurance
• Hedge funds
• Mutual funds not reported elsewhere

Page 9
PART 7 – ACTUARIAL INFORMATION FOR DEFINED BENEFIT PLANS

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To complete this part, continue using the CAFR or annual report used to complete the previous parts of
the form. Use this report even though more recent data may be available.
14

Are actuarial data available for this plan?
Yes – Continue
No – Go to Part 8, Remarks

15

$Bil.

Total Pension Liability
Mil.
Thou.

Dol.

$Bil.

Fiduciary Net Position
Mil.
Thou.

Dol.

What is the employers’ total pension liability
(TPL) for this plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16

What is the fiduciary net position (FNP) for this
plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17

Calculation of net pension liability (NPL) (Difference
of FNP reported in 16 and TPL reported in 15) . . . . . . . . . . .

18

Calculated ratio of financial net position (FNP)
to employer’s total pension liability (TPL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Actuarially Determined Contribution
$Bil.
Mil.
Thou.
Dol.

19

20

What is the actuarially determined contribution
amount for this plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$Bil.

Contribution Received
Mil.
Thou.

Dol.

$Bil.

Covered-Employee Payroll
Mil.
Thou.

Dol.

What were the contributions actually received in
relation to the actuarial determined contribution
for this plan?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

What is the amount of covered-employee payroll
for this plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22

What is the current discount rate for this plan
(also called the investment rate of return)?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23

The table below asks about the sensitivity of net pension liability/(asset) to changes in the discount
rate for this plan. What is the amount of the net pension liability with a 1% decrease in the discount
rate? What is the amount of the net pension liability with a 1% increase in the discount rate?
One Percent Decrease

Rate
Net pension
liability

Worksheet F-11

Current Rate

One Percent Increase

%

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Page 10
PART 8 – REMARKS
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 difficulties encountered in completing this worksheet

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PART 9 – CONTACT INFORMATION
25

Who should be contacted to answer questions about data reported on this survey?

Area code and phone number

Email Address

Title of contact person

Extension

Area code and fax number

Date completed
(MM)
(DD)

(YYYY)

Thank you for completing this survey.
Retain a copy of the completed report for your records.
NOTE: Title 13 United States Code (U.S.C.), Sections 161 and 182 authorizes the Census Bureau to conduct this collection. These data are subject to
provisions of Title 13, U.S.C., Section 9(b) exempting data that are customarily provided in public records from rules of confidentiality. Per the Federal
Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.
This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number is 0607-0585 and appears at
the upper right of this screen. Without this approval, we could not conduct this survey.
We estimate this survey will take an average of 2.5 hours to complete, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information.

Worksheet F-11

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Name of contact person