Various Governments Area Pretesting Activities

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

F-70

QUARTERLY
SURVEY OF LOCAL GOVERNMENT TAXES
Report for Quarter Ending: June 30, 2012

(10-16-2012) Draft 9

OMB No. 0607-0143: Approval Expires 06/30/2014

DUE DATE:

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

Need help or have
questions?
• Visit
census.gov/govs/qtax
• Call
1-866-880-9010 weekdays,
7am to 5pm ET
• Email
[email protected]
In correspondence
pertaining to this report,
please refer to the User
ID below the address box.
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:
respond.census.gov/qtax

User ID:
➤
Password:

GENERAL INSTRUCTIONS
1.

Report figures for the calendar quarter named in the form title.

2.

You may report on either a cash or accrual basis.

3.

Do not delay reporting to await final figures, if substantially accurate figures can be supplied on a preliminary
basis.

4.

To report revisions to any of the prior seven quarters, call 1-866-880-9010.

5.

Use a black or blue ballpoint pen. Do not use pencil or felt-tip pen.

1

Is your addressee title/department and mailing address the same as shown in the address label?
Mark "X" only one box.
Yes – Go to 2

No – Enter correct information below

Addressee Title or Department

17702010

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

ATTN:
Street 1

Street 2

City

State

Zip Code

Please continue on the next page

Page 2

CORRECT marking example –
Please print all information clearly in ordinary
characters. (Use care to keep characters in their
respective boxes.)

HOW TO
REPORT
DOLLAR
FIGURES

2

$Bil.

Mil.

Thou.

Dol.

1 2 3

4 5 6

7 8 0

INCORRECT marking example –
Do not put slashes through "0" or "7".
$Bil.

Mil.

Thou.

Dol.

7

8 9 0

What was the amount of tax collections from taxes imposed by your government for the quarter
ending June 30, 2012? Report zero for any item that has no collection for this quarter. Mark "X" the N/A box
for any item that is not applicable for your government.
Include
• Collections during the quarter from all levies for all funds of your government, and its agencies
• Taxes collected for your government by another government or authorized agency
• Current and delinquent amounts, penalties, and interest
Exclude
• Any taxes you collected on behalf of other governments
• Shares of taxes imposed by another government
A. Property taxes - All taxes on property, real or personal.
Include
• Special property taxes (e.g., automobiles or
intangible property)
Exclude
• Payments in lieu of taxes
• Special assessments based on area or footage.

N/A

$Bil.

Mil.

Thou.

Dol.

T01

B. Local sales taxes
Include
• Taxes on goods and services, measured as a percent of sales or receipts, or as an amount per unit
sold (e.g., gallon, package, etc.)
• Only taxes imposed by your government
Exclude
• Taxes imposed on the sale of particular commodities, businesses, or services (e.g., hotel/motel, car
rental, amusements, etc.)
• Sales tax distributions for revenue sharing from State or from other governments
General sales and gross receipts taxes

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Include
• Sales and use taxes
• Taxes applicable with only specified
exceptions (e.g., food and prescribed
medicines) to sales of all goods and
services or to all gross receipts, whether
at a single rate or at classified rates. . . . . .

Form F-70

2.

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

T09

Alcoholic beverages sales tax
Include
• Taxes on sale of alcoholic beverages,
whether collected through governmentoperated liquor stores or through private
outlets . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

N/A

N/A

17702028

1.

T10

Motor fuels sales tax
Include
• Taxes on gasoline, diesel oil, aviation
fuel, gasohol, ethanol, and any other
fuels used in motor vehicles or aircraft . . .

N/A
T13

Please continue on the next page

Page 3

4.

Tobacco products tax
Include
• Taxes on sale of tobacco products and
synthetic-cigars and cigarettes, including
related products like cigarette tubes and
paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

N/A

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

T16

C. Motor vehicles licensing and permit taxes
Include
• License and permit fees exacted (either for revenue
raising or for regulation) as a condition to the exercise
of a business or nonbusiness privilege
• Current and delinquent amounts, penalties, and
interest
• Licenses imposed on owners or operators of motor
vehicles for the right to use public highways, such as
fees for title registration, license plates, vehicle
inspection, vehicle mileage and weight taxes on motor
carriers, highway use taxes, and off-highway fees
• Vehicle sticker fees required to operate motor vehicles
• Licenses for the privilege of driving motor vehicles
both commercial and private
Exclude
• Receipts from service charges, special
N/A
assessments, interest earnings, fines, and
any other sources that are not taxes or
license fees . . . . . . . . . . . . . . . . . . . . . . . . . . . T24
D. Local income taxes
Local individual income taxes
Include
• Taxes on individuals measured by net income
and taxes on special types of income (e.g.,
interest, dividends, income from intangible
property, etc.)
Exclude
N/A
• Income taxes distribution for revenue
sharing from the state or from other
governments . . . . . . . . . . . . . . . . . . . . . . . T40

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2.

Form F-70

Local corporation net income taxes
Include
• Taxes on corporations and unincorporated
businesses (when taxed separately from
individual income), measured by net
N/A
income, whether on corporations in general
or on specific kinds of corporations, such
as financial institutions . . . . . . . . . . . . . . . T41

17702036

1.

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3

Use this space for any explanations that may be essential in understanding the reported data.
Include
• Any significant changes occurring within the last quarter that would aid in the understanding of this report
• Any difficulties you encountered in completing this form

Who should be contacted to answer questions about data reported on this form?
Name of contact person - Please print

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Area code and phone number

E-mail Address - Please print

Title of contact person - Please print

Extension

Area code and fax number

Date form was completed
(MM)
(DD)
(YYYY)

Thank you for completing this form.
Retain a copy of the completed questionnaire for your records.
NOTE: The U.S. Census Bureau receives its authorization to conduct this survey from Title 13, United States Code, Section 161. This form has been approved by the Office of
Management and Budget (OMB) and given the number 0607-0143. 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 was not displayed, under the Paperwork Reduction Act, we could not request your participation in this
voluntary survey. Information provided on this questionnaire compiled from or customarily provided in public records are exempt from confidential treatment as cited in Title 13,
United States Code, Section 9.
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 population served, and the extent and
complexity of their activities. Public reporting burden for this collection of information is estimated to vary from 10 minutes to 1 hour per response, with an average of 20 minutes
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, 4600 Silver Hill Road, AMSD-3K138, Washington, DC 20233. You may e-mail comments to [email protected]; use Paperwork Project
0607-0143 as the subject.

Form F-70

17702044

4