Form F-11 ANNUAL SURVEY OF PUBLIC PENSION PLANS Locally-Administer

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

U.S. CENSUS BUREAU
WORKSHEET

F-11

2019 ANNUAL
SURVEY OF PUBLIC PENSION PLANS
Locally-Administered Defined Benefit Plans
OMB No. 0607-0585: Approval Expires 07/31/2023

(08-07-2019)

WORKSHEET

November 12, 2019

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.

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questions?
• Visit
https://www.census.gov/
programs-surveys/aspp/
information.html
• Call
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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:
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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 20, 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 – ENDING DATE OF FISCAL YEAR

(MM)

2

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

3

What was the retirement system’s latest fiscal year end date that
occurred before July 1, 2019? Use this fiscal year data to complete
the remainder of this worksheet even though more recent data may be
available. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(MM)

(DD)

(DD)

(YYYY)

PART 2 – MEMBERSHIP AND BENEFITS FOR DEFINED BENEFIT PLANS
4

What was the total number of contributing members of the retirement system during the fiscal year
indicated in 3 ?
Number of
Exclude
Members
• Beneficiaries

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) . . . . . . . . . . . . . . . . . . . . . .

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

Worksheet F-11

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A. Active members – Current contributors in contributory systems or employees
in non-contributory systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 3

What was the total number of retirees and beneficiaries during the fiscal year indicated in 3 ?
Provide estimates if detailed data are not available.
Number of
Retirees/
Beneficiaries
A. Retirees and beneficiaries of system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART 3 – RECEIPTS FOR DEFINED BENEFIT PLANS
6

What was the amount of receipts during the fiscal year indicated in 3 ?
Exclude
• Amounts received from sales of investments
• Amounts received from repayment of loans made to members
$Bil.

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5

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)
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 . . . . . . . . . . .

Employer (Government)
Contributions
Mil.
Thou.
Dol.

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 . . . . . . . . . . . . . . . . . . . . . . . .
C. Earnings on investments

Exclude
• Gains and losses on investment transactions
(should be reported in 7 )

$Bil.

Investment Earnings
Thou.
Mil.

Dol.

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

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

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

Worksheet F-11

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Include
• Interest
• Dividends
• Rents
• Other earnings on investments

Page 4

What was the amount of net gains and losses on investments during the fiscal year indicated in 3 ?
Report losses as a negative value.
Gains and Losses
$Bil.

Mil.

Thou.

Dol.

Payments
Thou.

Dol.

A. Realized and unrealized gains or losses on
investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART 4 – PAYMENTS FOR DEFINED BENEFIT PLANS
8

What was the amount of payments during the fiscal year indicated in 3 ?
Exclude
• Amounts paid out for purchase of investments and loans made to members
$Bil.

Mil.

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7

A. Benefit payments – Report annual amounts . . . . . . . . . . . . . . .
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 . . . . . . . . . . . . . . . . . . . . . . .

PART 5 – CASH AND INVESTMENTS FOR DEFINED BENEFIT PLANS
9

What was the total amount of cash and investments (at market value) held at the end of the fiscal
year indicated in 3 ?
A. Cash and short-term investments

B. Long-term investments
Include
• Equities
• Fixed income
• Real property
• Other securities and investments . . . . . . . . . . . . . .

$Bil.

Cash and Short-term
Investments
Mil.
Thou.

Dol.

$Bil.

Long-term Investments
Mil.
Thou.

Dol.

$Bil.

Cash and Investments
Mil.
Thou.

Dol.

C. TOTAL – (Sum of totals for items A. and B.) . . . . . . . . .

Worksheet F-11

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Include
• Cash on hand
• Demand deposits
• Time or savings deposits
• Repurchase agreements
• Commercial company paper
• Bankers acceptances
• Money market mutual funds . . . . . . . . . . . . . . . . . .

Page 5
PART 6 – 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.
10

Are actuarial data available for this plan?
Yes – Continue
No – Go to Part 7, Remarks

11

$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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12

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

13

Calculation of net pension liability (NPL) (Difference
of FNP reported in 12 and TPL reported in 11) . . . . . . . . . . .

14

Calculated ratio of financial net position (FNP)
to employer’s total pension liability (TPL) (FNP
reported in 12 divided by TPL reported in 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Actuarially Determined Contribution
$Bil.
Mil.
Thou.
Dol.

15

16

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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18

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

19

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 6
PART 7 – 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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20

PART 8 – CONTACT INFORMATION
21

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