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

Attachment 2
U.S. DEPARTMENT OF COMMERCE
U.S. CENSUS BUREAU
(8-4-2010)

2019 ANNUAL
SURVEY OF LOCAL GOVERNMENT FINANCES
Multi-Function Special Agencies

WORKSHEET

F-29

OMB No. 0607-0585: Approval Expires 07/31/2023

(10/09/2019)

WORKSHEET

February 18, 2020

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:
https://respond.census.gov/alfin

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

2.

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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1.

Page 2

2

Which one of the following indicates the ending date of this agency’s fiscal year that ended between
July 1, 2018 and June 30, 2019? Use this fiscal year even though a more recent one may be available. Mark
"X" only one box.
2018

2019

July

October

January

April

August

November

February

May

September

December

March

June

PART 2 – GOVERNMENT ACTIVITY
3

Was this government active during the fiscal year indicated in question 2 ?

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PART 1 – ENDING DATE OF FISCAL YEAR

Yes - Go to 4
No - Continue
Please indicate the reason this government was inactive during the fiscal year indicated in question 2 .
Closed
Open with no revenue or expenditures
Never existed
Other – Specify: C

PART 3 – REVENUES
4

What was the amount of tax collections during the fiscal year indicated in 2 from all taxes imposed
by this agency?

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.
Exclude
• Taxes not measured by value
• Payments in lieu of taxes (should be reported in 5 and/or 6 )

$Mil.

Thou.

Dol.

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

Thou.

Dol.

..
Worksheet F-29

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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

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 14 )
• Maintenance assessments (should be reported in item A.) . . . .

Other Revenues
$Mil.

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 4 ) . . . . . . . . . . . . . . . . . . . .

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PART 3 – 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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H. Miscellaneous other revenues - Revenues of this agency not
reported in items A. through G. or questions 4 through 5 .
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 . . . . . . . . . . .

Total Revenues
$Bil.

7

Mil.

Thou.

Dol.

What was the total amount of revenues reported on this
worksheet (Sum of 4 through 6 )? . . . . . . . . . . . . . . . . . . . . . .

Worksheet F-29

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Page 6

8

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 9
No – Go to 10

9

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.).

Payment Made to
Other Local Governments

$Mil.

Thou.

Dol.

Payment Made to
State Government

$Mil.

Thou.

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PART 4 – EXPENDITURES

Dol.

A.
Specify:

B.
Specify:

C.
Specify:

D.

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Specify:

E.
Specify:

Worksheet F-29

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Page 7

10

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 9 )
• Benefits and payments from self-administered employee pension plans
• Interest on debt (should be reported in 11 )
Specify purpose - (e.g., water, sewer, natural resources, solid waste, highways, electric generation, parks
and recreation, airports, etc.).
A. 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 . . . . . . . . . . .

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PART 4 – EXPENDITURES - Continued

Direct Expenditures
$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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

B. Purpose - Specify:
1. Direct expenditures for employee compensation and for supplies,
materials, operating leases, and contractual services

Direct Expenditures
$Mil.

Thou.

Dol.

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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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Continue with 10 on the next page
Worksheet F-29

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Page 8

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 . . . . . . . . . . .

Direct Expenditures
$Mil.

Thou.

Dol.

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

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PART 4 – EXPENDITURES - Continued

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

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 . . . . . . . . . . .

Direct Expenditures
$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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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
$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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Worksheet F-29

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E. Purpose - Specify:

Page 9

11

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 14 )

Interest Expenditures
$Mil.

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.

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PART 4 – EXPENDITURES - Continued

Total Expenditures
$Bil.

12

What was the total amount of expenditures reported
on this form (Sum of 9 through 11 )? . . . . . . . . . . . . . . . . . . . .

13

What was the total amount of expenditures for salaries and
wages reported in 10 ?

Mil.

Thou.

Dol.

Personnel Expenditures
$Bil.

Mil.

Thou.

Dol.

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

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Worksheet F-29

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Page 10

14

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 10 )
• 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 5 – 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) . . . . . . . . . . . . . . . . . . . . . . . . -

15

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 14 )

Short-term Debt
$Bil.

Mil.

Thou.

Dol.

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

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

Worksheet F-29

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4. Outstanding total at end of fiscal year
(items B1. + B2. - B3.) . . . . . . . . . . . . . . . . . . . . . . . . . =