F-29 ANNUAL SURVEY OF LOCAL GOVERNMENT FINANCES Multi-Functio

Attachment 2
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
(8-4-2010)

WORKSHEET

F-29 (07/27/2018)

2018 ANNUAL
SURVEY OF LOCAL GOVERNMENT FINANCES
Multi-Function Special Agencies
OMB No. 0607-0585: Approval Expires 06/30/2020

December 18, 2018

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/alfin when you are ready to report online.

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

ATTN:

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

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DUE DATE:

-

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:
http://respond.census.gov/alfin

GENERAL INSTRUCTIONS

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

Please report amounts covering all funds and accounts of this agency except for any employee retirement funds
administered by this 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 this agency.
You may report on either a cash or accrual basis.

3.

As this survey is used for various kinds of agencies, some of the items may not apply to this agency. However,
read carefully the definition of each item to determine whether it applies to any of this agency’s transactions.

4.

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

1

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

No – Enter correct information below

Addressee Title or Department

ATTN:
Street 1

Street 2

City

State

Zip Code

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2.

Page 2

2

Which one of the following indicates the ending date of this agency’s fiscal year that ended between
July 1, 2017 and June 30, 2018? Use this fiscal year even though a more recent one may be available.
2017

2018

July

October

January

April

August

November

February

May

September

December

March

June

PART 2 – REVENUES

3

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PART 1 – ENDING DATE OF FISCAL YEAR

What was the amount of tax collections during the fiscal year indicated in 2 from all taxes imposed
by this agency?
Include
• Levies for debt service
• Levies for contributions to pension funds
• Levies for other funds or purposes
• Special property taxes (e.g., automobiles or intangible property)
• Taxes collected for this agency by another government
• Current and delinquent amounts, penalties, and interest
Exclude
• Receipts from service charges
• Special assessments
• Interest earnings
• Fines
• Any other sources that are not taxes or licenses

Property Taxes

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

Mil.

$Bil.

Mil.

Thou.

Dol.

T01

B. Taxes other than property taxes - Specify: C
Other Taxes
Thou.

Dol.

..

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Exclude
• Taxes not measured by value
• Payments in lieu of taxes (should be reported in 4 and/or 5 )

$Bil.

Page 3

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PART 2 – REVENUES - Continued
4

What was the amount of intergovernmental revenues received by this agency from other
governments during the fiscal year indicated in 2 ?
Include
• Grants
• Shares of taxes imposed by other governments
• Payments in lieu of taxes
• Reimbursements for services performed for other governments
• Payments under the American Recovery and Reinvestment Act of 2009 (ARRA)
Exclude
• Loans
• Any taxes imposed by this agency which were collected for it by another government (should be
reported in 3 )
• Receipts from utility sales to other governments (should be reported in 5 )
Specify and report revenue by purpose - (e.g., water supply, streets and highways, sewerage, transit, health,
and hospitals, etc.).

A. Purpose - Specify:

Intergovernmental Revenues
$Bil.

1.

From other local governments . . . . . . . . . . . . . . . . . . . . . . . . .

2.

From the State
Include
• Any amounts financed wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude
• Collection fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

From the Federal government directly . . . . . . . . . . . . . . . . . . .

Mil.

Thou.

Dol.

B. Purpose - Specify:
From other local governments . . . . . . . . . . . . . . . . . . . . . . . . .

2.

From the State
Include
• Any amounts financed wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude
• Collection fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

From the Federal government directly . . . . . . . . . . . . . . . . . . .

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1.

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Page 4

C. Purpose - Specify:

Intergovernmental Revenues
$Bil.

1.

From other local governments . . . . . . . . . . . . . . . . . . . . . . . . .

2.

From the State
Include
• Any amounts financed wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude
• Collection fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

From the Federal government directly . . . . . . . . . . . . . . . . . . .

Mil.

Thou.

Dol.

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PART 2 – REVENUES - Continued

D. Purpose - Specify:

5

1.

From other local governments . . . . . . . . . . . . . . . . . . . . . . . . .

2.

From the State
Include
• Any amounts financed wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude
• Collection fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

From the Federal government directly . . . . . . . . . . . . . . . . . . .

What was the amount of revenues, other than tax and intergovernmental revenues, received by this
agency during the fiscal year indicated in 2 ?
Include
• Revenues of all funds
Exclude
• Refunds and transfers between funds and accounts of this agency

Include
• Utility services, including sales to the Federal, State, or other local governments
Exclude
• Grants and other amounts received from the Federal, State, or other local governments (should be
reported in 4 )
Specify and report revenue by type of current charges:
(e.g., water supply, sewerage, solid waste, electric supply,
Current Charges
parks and recreation, natural resources, airports, etc.).
Mil.
Thou.
Dol.
$Bil.
1.
2.
3.
4.
4 on the next page
Continue with 5

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A. Current charges - Gross receipts from fees, sales, rentals, tolls, maintenance assessments, and other
charges for commodities or services.

Page 5

B. Special assessments - Compulsory contributions and
reimbursements from owners of property benefited by
improvements (e.g., streets, sewers, sidewalks, water extensions, etc.)
as well as for servicing special assessment debt.
Exclude
• Proceeds from sales of special assessment bonds
(should be reported in 13 )
• Maintenance assessments (should be reported in item A.) . . . .

Other Revenues
Mil.

$Bil.

Thou.

Dol.

C. Receipts from sale of property and other capital assets
Include
• Property sold to other governments
Exclude
• Tax sales (should be reported in 3 ) . . . . . . . . . . . . . . . . . . . .

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PART 2 – REVENUES - Continued

D. Interest earnings - Interest received on all deposits
and investment holdings of this agency.
Include
• Interest on construction funds
Exclude
• Interest earnings of any employee pension funds . . . . . . . . . . .
E.

Fines and forfeits - Receipts from penalties imposed for
violations of law and civil penalties . . . . . . . . . . . . . . . . . . . . . . . . .

F.

Royalties - Compensation or portion of proceeds from
extraction of natural resources (e.g., oil, gas, and
mineral rights) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

G. Private donations - Gifts of cash or securities from private
individuals or corporations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

H. Miscellaneous other revenues - Revenues of this agency not
reported in items A. through G. or questions 3 through 4 .

Total Revenues
$Bil.

6

Mil.

Thou.

Dol.

What was the total amount of revenues reported on this

worksheet (Sum of 3 through 5 )?. . . . . . . . . . . . . . . . . . . . . . . . .

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Include
• Insurance claims
• Recoveries of prior year expenditures
• Dividends
• Recorded profits from sale of investments
• Payments in lieu of taxes from private sources
Exclude
• Proceeds from borrowing
• Receipts from sale of security holdings
• Transfers between funds or accounts of this agency
• Employee contributions to employee pension funds
• Interest earnings of any employee pension funds. . . . . . . . . . . .

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7

Were payments made to other governments for services or programs performed on a reimbursement
or cost-sharing basis (i.e., intergovernmental expenditures) during the fiscal year indicated in 2 ?
Yes – Go to 8
No – Go to 9

8

What were the payments made to other governments during the fiscal year indicated in 2 ?
Function - (e.g., water
supply, sewerage, electricity,
fire protection, airports,
natural resources, housing
and community development,
solid waste, etc.). Specify: C

Type of
recipient government (e.g., municipality, school
district, county, State, etc.).
Specify: C

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PART 3 – EXPENDITURES

Intergovernmental Expenditures
$Bil.

Mil.

Thou.

Dol.

A.
B.
C.
D.
9

What was the amount of direct expenditures by purpose and type during the fiscal year indicated in 2 ?
Include
• Expenditures of all funds other than employee-retirement funds administered by this agency
Exclude
• Transfer between funds or accounts of this agency
• Payments made to other governments (should be reported in 8 )
• Benefits and payments from self-administered employee pension plans
• Interest on debt (should be reported in 10 )
Specify purpose - (e.g., water, sewer, natural resources, solid waste, highways, electric generation, parks
and recreation, airports, etc.).

1. 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 . . . . . . . . . . .

Direct Expenditures
$Bil.

Mil.

Thou.

Dol.

2. Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . . .
3. Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gxx

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A. Purpose - Specify:

Page 7

B. Purpose - Specify:
1. 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 . . . . . . . . . . .

Direct Expenditures
$Bil.

Mil.

Thou.

Dol.

2. Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . . .

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PART 3 – EXPENDITURES - Continued

3. Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

C. Purpose - Specify:
1. 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 . . . . . . . . . . .
2. Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . . .
3. Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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D. Purpose - Specify:
1. 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 . . . . . . . . . . .
2. Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . . .
3. Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Page 8

E. Purpose - Specify:
1. Direct expenditures for employee compensation and for supplies,
materials, operating leases, and contractual services
Include
• Gross salaries and wages before deductions

Direct Expenditures
Mil.

$Bil.

Thou.

Dol.

Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .
2. Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . . .

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PART 3 – EXPENDITURES - Continued

3. Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10

What was the total amount of interest paid on long-term and short-term debt held by this agency
during the fiscal year indicated in 2 ?
Include
• Capitalized interest paid on construction loans
Exclude
• Debt retirement (should be reported in 13 )

Interest Expenditures
Mil.

$Bil.

A.

Interest on water supply system debt . . . . . . . . . . . . . . . . . . . .

B.

Interest on electric power system debt. . . . . . . . . . . . . . . . . . .

C.

Interest on gas supply system debt. . . . . . . . . . . . . . . . . . . . . . .

D.

Interest on transit or bus system debt . . . . . . . . . . . . . . . . . . .

E.

Interest on all other debt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Thou.

Dol.

11

What was the total amount of expenditures reported on

12

What was the total amount of expenditures for salaries and
wages reported in 9 ?

Mil.

Thou.

Dol.

this worksheet (Sum of 8 through 10 )? . . . . . . . . . . . . . . . . . . . .

Personnel Expenditures
$Bil.

Mil.

Thou.

Dol.

Exclude
• Fringe benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Total Expenditures
$Bil.

Page 9

13

What was the total amount of long-term debt held by this agency for the fiscal year indicated in 2 ?
Report 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 (should be reported in 9 )
• Amounts for compensated absences
A. What was this agency’s debt for all public purposes?

Long-term Debt
for Public Purposes
$Bil.

Mil.

Thou.

Dol.

1. Outstanding at beginning of fiscal year . . . . . . . . . . . . +

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PART 4 – INDEBTEDNESS

2. Issued during fiscal year
(include all refunding issues) . . . . . . . . . . . . . . . . . . . . +
3. Retired during fiscal year
(include debt refunded) . . . . . . . . . . . . . . . . . . . . . . . . 4. Outstanding total at end of fiscal year
(items A1. + A2. - A3.) . . . . . . . . . . . . . . . . . . . . . . . . . =
B. What was this 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, conduit debt, etc.).
$Bil.

Long-term Debt
for Private Purposes
Mil.

Thou.

Dol.

1. Outstanding at beginning of fiscal year . . . . . . . . . . . . +
2. Issued during fiscal year
(include all refunding issues) . . . . . . . . . . . . . . . . . . . . +
3. Retired during fiscal year
(include debt refunded) . . . . . . . . . . . . . . . . . . . . . . . . 4. Outstanding total at end of fiscal year
(items B1. + B2. - B3.) . . . . . . . . . . . . . . . . . . . . . . . . . =

What was the total amount of short-term debt held by this agency for the fiscal year indicated in 2 ?
Report 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
• Current portion of long-term debt (should be reported as
long-term debt in 13 )

Short-term Debt
$Bil.

Mil.

Thou.

Dol.

A. Amount outstanding at beginning of fiscal year. . . . . . .
B. Amount outstanding at end of fiscal year . . . . . . . . . . . .

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15

What was the total amount of cash and investments (at market value) held by this agency at the end
of the fiscal year indicated in 2 ?
Include
• 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
Exclude
• Accounts receivable
• Value of real property
• All non-security assets
• Employee retirement funds
A. 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
$Bil.

Mil.

Thou.

Dol.

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PART 5 – CASH AND INVESTMENTS HELD AT END OF FISCAL YEAR

B. Unexpended proceeds from sale of bond issues
held pending disbursement – (e.g., bond funds). . . . . .
C. All other cash and investments – Checking/savings
accounts, CDs, stocks, bonds, mutual funds, etc. . . . . . . .
PART 6 – REMARKS
16

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 survey

PART 7 – CONTACT INFORMATION
17

Who should be contacted to answer questions about data reported on this survey?
Name of contact persont

Email Address

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: The U.S. Census Bureau receives its authorization to conduct this survey from Title 13, United States Code, Sections 161 and 182. This survey has been approved by the
Office of Management and Budget (OMB) and given the number 0607-0585. Please note the number displayed in the upper right-hand corner of this worksheet. 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(b).
Please note that this is a national survey 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 2 hours to 8 hours per response, with an average of 3 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.

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Area code and phone number

Title of contact person