Form F-72 State Tax Collections, Quarterly Survey

F-72

OMB No. 0607-0112: Approval Expires 04/30/2009

F-72

A. Name of State

FORM
(3-12-2009)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

B. Period covered by this report
Quarter
Year

C. Office or agency

U.S. CENSUS BUREAU

STATE TAX
COLLECTIONS
QUARTERLY SURVEY

RETURN
TO

U. S. Census Bureau
Governments Division
Public Finance Branch B
Washington, DC 20233-6800

(Please correct any error in name, address, and ZIP Code)

FROM THE ACTING DIRECTOR
U.S. CENSUS BUREAU
We are writing to request information needed for our Quarterly Survey of Tax Collections. The Bureau of Economic Analysis will use
this information to develop estimates of the Gross Domestic Product—a key economic indicator.
The form on the reverse side shows the data we would like to have concerning your state’s tax collections of the past quarter.
Please note that figures may be entered either for the entire three-month period or on a month-by-month basis, whichever is more
convenient for you.
If actual amounts of tax collections during the past three months are not available, you may use reasonable estimates.
Please transmit your report within 30 days via the Internet at . You may also respond to
this survey by mail or fax (toll-free 1 (866) 803-0407).
The U.S. Census Bureau receives its authorization to conduct this voluntary survey from Title 13, United States Code, Section 182.
This form has been approved by the Office of Management and Budget (OMB) and given the number 0607-0112. Please note the
number displayed 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.
We estimate that it will take from 15 to 45 minutes to complete this form, with an average of 30 minutes per response, including the
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 0607-0112, U.S. Census Bureau, 4600 Silver Hill
Road, AMSD-3K138, Washington, DC 20233. You may e-mail comments to ; use “Paperwork Project
0607-0112” as the subject.
If you have any questions concerning this request, please call the Governments Division on our toll-free number, 1 (866) 820-7210.
Thank you for cooperating in this important survey. We are grateful for your help.
Sincerely,

Thomas L. Mesenbourg
Enclosure

INSTRUCTIONS
1. Please fill out and return this form within 30 days. FAX your
response toll-free to 866–803–0407 or 301–763–8770 (if
possible) or mail it to the address shown above.
2. Include estimates for items when final figures are not available
and mark with an "E."
3. Collection amounts are to be grouped according to the
classification system reflected on this form.

4. Please use the "Remarks" space on the reverse side to explain
sharp changes caused by other than normal seasonal
collection patterns (e.g., new tax sources, rate changes,
changes in deductions, etc.).
5. If you have any questions concerning this survey,
call the Finance Branch, Governments Division, at
1–866–820–7210.

INCLUDE —
a. Taxes of all funds and agencies — Collection aggregates for each tax source comprising amounts received by all
funds and agencies of your State government.
b. Protested taxes in revenue accounts — Amounts of protested taxes which have been transferred to revenue
accounts because of legal or administrative determination. (See instruction e.)
c. Delinquent taxes — Collections of delinquent taxes and applicable penalties and interest.
d. State collected-locally distributed taxes — Taxes imposed and received by the State government which are
subsequently distributed to local governments.
EXCLUDE —
e. Protested taxes in suspense accounts — Protested taxes paid into suspense funds. (See instruction b.)
f. Locally collected/retained taxes — Locally collected and retained amounts of State imposed taxes.
g. Discounts — Amounts representing discounts or commissions allowed taxpayers.
h. Locally retained tax collection costs — Amounts retained by local government or local officials representing tax
collection costs or fees.
i. Transfers between funds — Amounts representing transfers between funds (except for instruction b) or amounts
collected in a prior period and distributed to local governments during this period.

USCENSUSBUREAU

ID

State name

Period covered by this
report

TAX COLLECTIONS
(Net of refunds except when otherwise indicated)
Please report either in terms of 3-month totals or in
terms of individual month amounts whichever is more
convenient.
1. Property taxes
T01 $
a. Directly State-collected

Omit cents

$

Collections of locally imposed supplements to
State general sales taxes (net of State-retained
amount)
3. Motor fuel sales taxes
a. Gross collections
b. Refunds during period
T13

a. Alcoholic beverages

T10

b. Public utilities

T15

c. Insurance

T12

d. Tobacco products

T16

e. Pari-mutuels

T14

f. Amusements

T11

g. Other selective sales and gross receipts
5. License taxes
a. Alcoholic beverages

T19
T20

b. Public utilities

T27

c. Motor vehicles

T24

d. Motor vehicle operator

T25

e. Corporations in general

T22

f. Hunting and fishing licenses

T23

g. Amusements

T21

h. Occupation and business licenses not
elsewhere classified

T28
T29

i
. Other license taxes
6. Individual income taxes
a. Gross collections
b. Refunds during period
c. Net collections — (a minus b)

T40

7. Corporation net income taxes

T41

8. Death and gift taxes

T50

9. Severance taxes

T53

10. Documentary and stock transfer taxes

T51

11. Other miscellaneous taxes

T99

CENSUS USE ONLY

T77

13. Remarks

Name
12.
DATA
SUPPLIED Title
BY
Telephone
FORM F-72 (3-12-2009)

Area code

Number

Year

TOTAL

b. Received from local government collection
agencies
T02
2. General sales and gross receipts taxes
(and related use taxes)
a. State imposed taxes (plus any retained portion
T09
of local supplements)

c. Net collections — (a minus b)
4. Selective sales and gross receipts
taxes, other than motor fuel

Quarter

Extension

$

$