| ID:  46-01-01 | 
		
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		OMB: 0607-0112 | 
		
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		STATE OF XXXXX | 
		
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		Expires: 08/31/2019 | 
		
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		3/31/2019 | 
	
	
		
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		FISCAL YEAR: 2019 | 
		
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		For the Quarter Ending 03/31/2019 | 
		
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		Fiscal Year to Date | 
		
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		| 1.  PROPERTY TAXES | 
		
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		a.  Directly State-collected | 
		T01 | 
		
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		0  | 
		
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		0  | 
		
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		b.  Received from local government collection agencies | 
		T02 | 
		
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		0  | 
		
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		0  | 
		
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		| 2.   General Sales and Gross Receipts Taxes | 
		
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		 (and Related Use Taxes) | 
		
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		a.  State imposed taxes (plus any retained portion  | 
		
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		     of local supplements) | 
		T09 | 
		
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		0  | 
		
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		0  | 
		
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		b.  Collections of locally imposed supplements to | 
		
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		     state general sales taxes (net of State-retained amounts) | 
		
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		0  | 
		
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		0  | 
		
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		| 3.   MOTOR FUEL SALES TAXES | 
		
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		a.  Gross collections | 
		
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		0  | 
		
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		0  | 
		
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		b.  Refunds during period | 
		
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		0  | 
		
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		0  | 
		
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		c.  Net collections (a minus b) | 
		T13 | 
		
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		0  | 
		
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		0  | 
		
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		| 4.   SELECTIVE SALES AND GROSS RECEIPTS TAXES,  | 
		
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		OTHER THAN MOTOR FUEL | 
		
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		a.  Alcoholic beverages | 
		T10 | 
		
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		0  | 
		
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		0  | 
		
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		b.  Public utilities | 
		T15 | 
		
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		0  | 
		
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		0  | 
		
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		c.  Insurance | 
		T12 | 
		
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		0  | 
		
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		0  | 
		
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		d.  Tobacco products | 
		T16 | 
		
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		0  | 
		
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		0  | 
		
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		e.  Pari-mutuels | 
		T14 | 
		
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		0  | 
		
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		0  | 
		
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		f.  Amusements | 
		T11 | 
		
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		0  | 
		
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		0  | 
		
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		g.  Other selective sales and gross receipts | 
		T19 | 
		
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		0  | 
		
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		0  | 
		
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		| 5.   LICENSE TAXES | 
		
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		a.  Alcoholic beverages | 
		T20 | 
		
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		0  | 
		
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		0  | 
		
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		b.  Public utilities | 
		T27 | 
		
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		0  | 
		
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		0  | 
		
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		c.  Motor vehicles | 
		T24 | 
		
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		0  | 
		
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		0  | 
		
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		d.  Motor vehicle operators | 
		T25 | 
		
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		0  | 
		
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		0  | 
		
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		e.  Corporate in general | 
		T22 | 
		
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		0  | 
		
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		0  | 
		
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		f.   Hunting and fishing licenses | 
		T23 | 
		
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		0  | 
		
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		0  | 
		
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		g.  Amusements | 
		T21 | 
		
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		0  | 
		
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		0  | 
		
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		h.  Occupation and business licenses not elsewhere classified | 
		T28 | 
		
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		0  | 
		
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		0  | 
		
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		i.   Other license taxes | 
		T29 | 
		
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		0  | 
		
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		0  | 
		
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		| 6.   INDIVIDUAL INCOME TAXES | 
		
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		a.  Gross collections | 
		
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		0  | 
		
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		0  | 
		
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		b.  Refunds during the period | 
		
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		0  | 
		
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		0  | 
		
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		c.  Net collections (a minus b) | 
		T40 | 
		
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		0  | 
		
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		0  | 
		
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		| 7.   CORPORATE NET INCOME TAXES | 
		
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		T41 | 
		
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		0  | 
		
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		0  | 
		
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		| 8.   DEATH AND GIFT TAXES | 
		
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		T50 | 
		
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		0  | 
		
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		0  | 
		
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		| 9.  SEVERANCE TAXES | 
		
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		T53 | 
		
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		0  | 
		
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		0  | 
		
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		| 10.  DOCUMENTARY AND STOCK TRANSFER TAXES | 
		
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		T51 | 
		
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		0  | 
		
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		0  | 
		
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		| 11.  OTHER MISCELLANEOUS TAXES | 
		
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		T99 | 
		
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		0  | 
		
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		0  | 
		
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		|      CENSUS USE ONLY | 
		
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		T77 | 
		
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		| We estimate this survey will take an average of 30 minutes to complete, including time for reviewing instructions, searching existing data sources, | 
		
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		| gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden | 
		
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		| estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: | 
		
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		| ITMD Survey Comments 0607-0112 | 
		
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		| U.S. Census Bureau | 
		
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		| 4600 Silver Hill Road | 
		
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		| Room ITMD-5K158 | 
		
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		| Washington, DC 20233 | 
		
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		| You may e-mail comments to [email protected]; use "ITMD Survey Comments 0607-0112" as the subject. | 
		
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