Form F-71 Quarterly Survey of Property Tax Collections

F-71

OMB No. 0607-0112: Approval Expires 05/31/2012
In correspondence pertaining to this report, please refer
to the Census File Number above your address

F-71

FORM
(6-1-2009)

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

QUARTERLY
SURVEY OF PROPERTY
TAX COLLECTIONS

RETURN
TO

U. S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
(Please correct any error in name, address, and ZIP Code)

Please respond within 30 days to: http://harvester.census.gov/qtax/indexF71.aspx OR via mail.
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 need from your agency. If actual amounts of property 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 using the
enclosed addressed envelope. Respond either by Internet or mail, but not both.
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 righthand corner of this
form, confirming 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 10 to 20 minutes to complete this form, with an average of 15 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) 492-0140.
Thank you for cooperating in this important survey. We are grateful for your help.
Sincerely,

Thomas L. Mesenbourg

USCENSUSBUREAU

❶

What was the total amount of real and personal property tax
collected by your agency during the three (3) months ending
with
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$.

.00

Include:
• Current and delinquent amounts, penalties, and interest
• Amounts collected for the State or other local governments, including collection fees
(County, Municipal, Township, School District, or Special District)
• "Special" property taxes (e.g., automobiles or intangible property)
Exclude:
• Amounts collected for you by other governments
• Special assessments based on area or footage
• Any State payments, including property tax relief or homestead credits
• Payments in lieu of taxes

❷

❸

Remarks — If the collection amount reported was affected by some unusual development during the
past 12 months (such as a change in the tax calendar or in your collection relations with other
governments) please explain briefly.

CERTIFICATION

Name and title

Telephone
(Area code, number, extension)

FORM F-71 (6-1-2009)