F-32 Annual Survey of Local Government Finances - Special Age

F-32 (2004)

OMB No. 0607-0585: Approval Expires 03/31/2005

2004 Annual Survey of Local Government Finances
Special Agencies
U.S. DEPARTMENT OF COMMERCE

In correspondence pertaining to this report, please refer to the ID printed above your address.

Economics and Statistics Administration
U.S. CENSUS BUREAU

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

If you have any questions, please call
1–800–242–4523
weekdays, 7:00 a.m. to 5:00 p.m. EST.
Questions can also be emailed to:
[email protected]
Please correct any errors in name, address, or ZIP Code.

GENERAL INSTRUCTIONS
Before filling out this form, please read carefully each part and all related definitions and instructions.
Note especially:
1. Please report amounts, covering all funds and accounts of your agency except for any employee-retirement
funds administered by your 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 your
agency.
2. As this form is used for various kinds of agencies, some of the items may not apply to your agency. However,
read carefully the definition of each item to determine whether it applies to any of your agency’s transactions.
3. Do not delay reporting to await finally audited figures, if substantially accurate figures can be supplied on a
preliminary basis.
4. You may report on either a cash or accrual basis.

..Part 1..

ENDING DATE OF FISCAL YEAR

Mark (X) in the appropriate box below to indicate the ending date of your agency’s fiscal year
(12-month accounting period) and report data for this period only.
Use this fiscal year even though a more recent one may be available.
2003
July
August
September

2004
October
November
December

January
February
March

April
May
June

Please continue on the next page

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..Part 2.. TAX REVENUES

Page 2

Report collections during the fiscal year indicated in Part 1 from all taxes imposed by your agency.
Include current and delinquent amounts, penalties, and interest.
Exclude receipts from service charges, special assessments, interest earnings,
fines, and any other sources that are not taxes or licenses.

Property Taxes
T01

1. Property taxes – All taxes on property, real or personal……………………………

$

,

,

.00

Include levies for debt service, pension funds, and other funds or purposes.
Exclude taxes not measured by value.
2. Other taxes – specify

Other Taxes
T99

............................................................................................………

..Part 3..

$

,

,

.00

INTERGOVERNMENTAL REVENUES

Report all amounts received by your agency from other governments in the fiscal year indicated in Part 1.
Include:
• Grants
• Shares of taxes imposed by other governments
• Payments in lieu of taxes
• Reimbursements for services performed for other governments
Exclude:
• Loans
• Receipts from utility sales to other governments (Report in Part 4)
• Any taxes imposed by your agency which were collected for it by another government (Reported in Part 2)

Report total intergovernmental revenue received:

Intergovernmental Revenue
ZDD

$

,

,

.00

2. From the State - Report all amounts your agency received from the
ZCC
State, including any amounts financed wholly or in part from Federal
$
grants to the State.......................................................................……………………..

,

,

.00

,

,

.00

1. From other local governments...........................................................................…

ZBB
3. From the Federal government directly - Report only amounts received
$
directly from the Federal government......................................................................…

Please continue on the next page

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Page 3

..Part 4..

REVENUES - OTHER THAN TAX AND INTERGOVERNMENTAL REVENUES

Report other revenues received by your agency during the fiscal year indicated in Part 1.
Include revenues of all funds.
Exclude refunds and transfers between funds and accounts of your agency.
Other Revenues
1. Current charges - Receipts from fees, sales, rentals, tolls, maintenance
ZAA
$
assessments, and other charges for commodities and services…………..……….

,

,

.00

,

,

.00

Include property sold to other governments
U11
Exclude tax sales (Reported in Part 2)………………………………………….……... $

,

,

.00

4. Interest earnings - Interest received on all deposits and investment holdings of U20
your agency, excluding earnings of any employee pension fund……………………. $

,

,

.00

,

,

.00

$

,

,

.00

U50
7. Private donations - Gifts of cash or securities from private individuals or
$
corporations..............................................................................................………...

,

,

.00

8. Miscellaneous other revenues - Revenues not reported in items 1-7, or
U99
Parts 2 - 3… ………………………………………………………………………………
$

,

,

.00

Include utility services, including utility sales to local, State, or the Federal
governments.

2. Special assessments - Compulsory contributions and reimbursements from
owners of property benefited by improvements (streets, sewers, sidewalks,
U01
water extensions, etc.), as well as for servicing special assessment debt…………. $
Exclude proceeds from sales of special assessment bonds (Report in Part 7)
and maintenance assessments (Reported in item 1 above).

3. Receipts from sale of property and other capital assets -

Include interest on construction funds.

5. Fines and forfeits - Receipts from penalties imposed for violations of law and U30
civil penalties................………………………………....................................…........... $

U40

6. Rents and royalties - Revenue from temporary possession or use of
government-owned buildings, land, and other properties……………………………..

Include insurance claims, recoveries of prior year expenditures, dividends, and
recorded profits from sale of investments.
Exclude proceeds from borrowing, receipts from sale of security holdings,
transfers between funds or accounts of your agency, and employee’s
contributions to, and interest earnings of, any employee pension fund.
Total Revenues
REV

..Part 5.. TOTAL REVENUES (sum of Parts 2 - 4) ……………..……
Please continue on the next page

$

,

,

.00
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Page 4
..Part 6.. EXPENDITURES
Report amounts expended during the fiscal year indicated in Part 1.
Expenditures
ZFF

,

,

.0 0

$

,

,

.0 0

3. Interest on debt - Total amount of interest paid on all debt, long-term and
ZKK
$
short-term, of your agency…………………………………………………………………

,

,

.0 0

$

,

,

.0 0

$

,

,

.0 0

Include expenditures for salaries and wages, operating leases, rent, utility
ZEE
services, and materials and supplies for current operation and maintenance
$
and all other expenditures……………………………………………..………….……...

,

,

.0 0

1. Expenditures for construction - Major repairs and alterations…………….………… $
Include amounts for construction performed on a contract basis, and also any
expenditures for construction carried out by personnel of this agency.
Exclude interest capitalized as a cost of construction (Report in item 3 below).

2. Purchase of equipment, land, and existing structures
Include amounts for replacement and additional equipment as well as for
lease purchase installment contracts…………….. ………………………………......

ZGG

Include capitalized interest paid on construction loans.
Exclude debt retirement (Report in Part 7).

4. Payments to other governments - Payments in lieu of taxes, reimbursements
for services received, etc.
ZLL

A. To State government........................................................................…..….....
ZMM

B. To local governments...................................................................…....………

5. All other expenditures - All expenditures other than for items covered above.

Exclude
• Payments for retirement of debt
• Payments for purchase of securities
• Transfers between funds and accounts of your agency
• Provisions for depreciation
Total Expenditures
EXP

6. TOTAL EXPENDITURES (Sum of lines 1 - 5).....…......………….........………........

Please continue on the next page

$

,

,

.0 0

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Page 5
..Part 7.. INDEBTEDNESS
..Long-term Debt...........................................................................................................................................................
Bonds, mortgages, etc., with an original term of more than one year, including revenue bonds and special
assessment bonds as well as general obligations.
Include debt refunded.
Exclude:
• capital leases (Reported in .Part 7.)
• amounts for compensated absences

Long-term Debt
for Public Purposes

1. What is your agency’s debt for all public purposes?
19X

$

,

,

.00

$

,

,

.00

$
C. Retired during fiscal year (include debt refunded).........................…......…. -

,

,

.00

,

,

.00

A. Outstanding at beginning of fiscal year..............................................…...

+
29X

B. Issued during fiscal year (include all refunding issues)..........................…. +
39X

49X

$
D. Outstanding total at end of fiscal year (Item A + B - C).....................…..... =

2. What is your 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, etc.)
19T

Long-Term Debt
for Private Purposes
$

,

,

.00

B. Issued during fiscal year (include all refunding issues)....…................…… + $

,

,

.00

$

,

,

.00

D. Outstanding total at end of fiscal year (Item A + B - C)............…………… = $

,

,

.00

A. Outstanding at beginning of fiscal year.............................................…...

+
29T

39T

C. Retired during fiscal year (include debt refunded)......………................….. 49T

..Short-term (interest-bearing) Debt...........................................................................................................................
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, and current
portion of long-term debt (Reported as long-term debt above).

Short-term Debt
61V

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

$

,

,

.00

$

,

,

.00

64V

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

Please continue on the next page

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Page 6
.Part 8.. CASH AND INVESTMENTS HELD AT END OF FISCAL YEAR
Report cash and investments held at the end of the fiscal year indicated in Part 1, including:
•
•

The 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.

Report all investments at market value.
Exclude accounts receivable, value of real property, and all non-security assets.

Amount at end of fiscal year
1. Reserves held for redemption of long-term debt (e.g. sinking or debt service W01
,
,
.00
funds).………………………………………………………………………………………. $
Include any mortgages and notes receivable held as offsets
to housing and industrial financing loans.
2. Unexpended proceeds from sale of bond issues held pending disbursement W31
$
(e.g. bond funds)……………………………………………………………………………
3. All other cash and investments – checking/savings accounts, CD’s, stocks,
bonds, mutual funds, etc……………….……………………………..…………………

W61

$

,

,

.00

,

,

.00

Exclude employee retirement funds.
..Part 9..

REMARKS

..Part 10

CERTIFICATION

This report is substantially accurate and had been prepared in accordance with the instructions.
Name of person completing report – Please print

Title of person completing report

Telephone Number
Area Code

Number

Date form was completed

Email Address
Extension

Thank you for your report. Please return to:

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

This form has been approved by the Office of Management and Budget (OMB) and has been given the number 0607-0585. Please note that we have
displayed this number 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 were not displayed, we could not request your participation in this survey.
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 the population
served, and the extent and complexity of their financial account. We estimate public reporting burden for this collection of information to vary from 2.0
to 8.0 hours per response, with an average of 3.0 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 0607-0585, U.S. Census
Bureau, 4700 Silver Hill Road, Stop 1500, Washington, D.C. 20233-1500. You may e-mail comments to [email protected]; use "Paperwork
Project 0607-0585" as the subject.
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