F-28 ANNUAL SURVEY OF LOCAL GOVERNMENT FINANCES County, Munic

Attachment 2
2018 ANNUAL
SURVEY OF LOCAL GOVERNMENT FINANCES
County, Municipal, and Township

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
(8-4-2010)

WORKSHEET

F-28 (07/27/2018)

OMB No. 0607-0585: Approval Expires 06/30/2020

December 18, 2018

WORKSHEET
DO NOT use this worksheet to respond to the survey. It is intended to assist you
with gathering and preparing your data prior to reporting online.
Return to https://respond.census.gov/alfin when you are ready to report online.

Need help or have
questions?
• Visit
https://census.gov/govs/local
• Call
1-800-832-2839 weekdays,
8AM to 5PM ET

ATTN:

In correspondence
pertaining to this report,
please refer to the User
ID supplied in your letter.

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DUE DATE:

-

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:
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GENERAL INSTRUCTIONS

1

Is the addressee title/department and mailing address the same as shown in the letter?
Yes – Go to 2

No – Enter correct information below

Addressee Title or Department

ATTN:
Street 1

Street 2

City

State

Zip Code

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Before filling out this survey, please read carefully each part and all related definitions and instructions.
Note especially:
1.
Please report amounts covering all funds and accounts of this government except for any employee retirement
funds administered by this government. 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
this government.
2.
Exclude all school revenue and expenditures for school systems run by this government.
3.
You may report on either a cash or accrual basis.
As this survey is used for various kinds of governments, some of the items may not apply to this government.
4.
However, read carefully the definition of each item to determine whether it applies to any of this government’s
transactions.
5.
Do not delay reporting to await finally audited figures, if substantially accurate figures can be supplied on a
preliminary basis.

Page 2

2

Which one of the following indicates the ending date of this government’s fiscal year that ended
between July 1, 2017 and June 30, 2018? Use this fiscal year even though a more recent one may be
available. Mark "X" only one box.
2017

2018

July

October

January

April

August

November

February

May

September

December

March

June

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PART 1 – ENDING DATE OF FISCAL YEAR

PART 2 – REVENUES
3

What was the amount of tax collections during the fiscal year indicated in 2 from all taxes imposed
by this government?
Include
• Levies for debt service
• Levies for contributions to pension funds
• Levies for other funds or purposes
• Special property taxes (e.g., automobiles or intangible property)
• Taxes collected for this government by another government
• Current and delinquent amounts, penalties, and interest
Exclude
• Receipts from service charges
• Special assessments
• Interest earnings
• Fines
• Any other sources that are not taxes or licenses
A. Property taxes - All taxes on property, real or personal.
Report collections during the fiscal year from all levies for
all funds of this government, and its agencies.

Property Taxes
$Mil.

Thou.

Dol.

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Exclude
• Any taxes collected on behalf of other governments
• Taxes not measured by value
• Payments in lieu of taxes (should be reported in 4 and/or 5 )

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Page 3
PART 2 – REVENUES - Continued
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 this government
Exclude
• Shares of taxes imposed by another government (should be
reported in 4 )
1.

General sales and gross receipts taxes
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Tax Revenues
$Mil.

Thou.

Dol.

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

3.

Amusements sales tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

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

5.

Parimutuels tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

Public utilities sales tax
Include
• Taxes imposed distinctively on public utilities, and
measured by gross receipts, gross earnings, or units
of service sold, either as a direct tax on consumers
or as a percentage of gross receipts of utility
• Telephone, cable, and other telecom taxes (e.g., 911
taxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.

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

8.

Other sales tax – Specify: C
...

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Page 4

C. Licensing and permit taxes - (e.g., license and permit fees exacted (either for revenue raising or for
regulation) as a condition to the exercise of a business or nonbusiness privilege.)
Tax Revenues
$Mil.

1.

Alcoholic beverages licensing and permit taxes . . . . . . . . . . . .

2.

Amusements licensing and permit taxes . . . . . . . . . . . . . . . . . .

3.

Motor vehicles licensing and permit taxes. . . . . . . . . . . . . . . . .

4.

Public utilities licensing and permit taxes . . . . . . . . . . . . . . . . .

5.

Occupation and business licensing and permit taxes
(not reported above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

Other licensing and permit taxes – Specify: C

Thou.

Dol.

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PART 2 – REVENUES - Continued

...
D. Local income taxes
1.

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
• Income tax distribution for revenue sharing from
the State or from other governments . . . . . . . . . . . . . . . . .

2.

Local corporation net income tax

E.

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Include
• Taxes on corporations and unincorporated businesses
(when taxed separately from individual income),
measured by net income, whether on corporations in
general or on specific kinds of corporations, such as
financial institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other taxes
1.

Death and gift tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Documentary and stock transfer tax . . . . . . . . . . . . . . . . . . . . .

3.

Severance tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

Other taxes – Specify: C

...
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Page 5

4

What was the amount of intergovernmental revenues received by this government from other
governments during the fiscal year indicated in 2 ?
Include
• Grants
• Shares of taxes imposed by other governments
• Payments in lieu of taxes
• Reimbursements for services performed for other governments
• Payments under the American Recovery and Reinvestment Act of 2009 (ARRA)
Exclude
• Loans
• Any taxes imposed by this government which were collected for it by another government (should be
reported in 3 )
• Receipts from utility sales to other governments (should be reported in 5 )
From the State
Include any amounts financed
wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude collection fees

From other local
governments

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PART 2 – REVENUES - Continued

From the Federal
government directly

A. Streets and highways
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

B. Public welfare (including Medicaid)

C. Health and/or hospitals

D. Housing and community development

Water supply system

F.

Sewerage

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E.

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Page 6

From the State
Include any amounts financed
wholly or in part from Federal
grants to the State (i.e., pass-throughs)
Exclude collection fees

From other local
governments

From the Federal
government directly

G. Electric power system
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

H. Gas supply system

I.

Mass transit rail and/or bus system

J.

Airports

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PART 2 – REVENUES - Continued

K. Natural resources - Aid for forests and grasslands; soil, water, and energy conservation; flood prevention and
drainage; fish and wildlife management; and mine reclamation and safety.

L.

General support (unrestricted) - (e.g., payments in lieu of taxes, revenue sharing, per capita aid, property tax
relief) - Specify: C

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M. All other - Specify: C

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Page 7

5

What was the amount of revenues, other than tax and intergovernmental revenues, received by this
government during the fiscal year indicated in 2 ?
Include
• Revenues of all funds
Exclude
• Refunds and transfers between funds and accounts of this government
A. Utility sales revenues - Gross receipts of any water, electric, gas, or
transit systems operated by this government, from utility sales and charges.
Include
• Amounts received from the sale of utility commodities and
services to the Federal, State, or other local governments

Utility Sales Revenues
$Mil.

1.

Water supply system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Electric power system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

Gas supply system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

Transit or bus system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Thou.

Dol.

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PART 2 – REVENUES - Continued

B. Other sales and service revenues - Gross receipts from fees,
sales, rentals, tolls, maintenance assessments, and other charges
for commodities or services.
Exclude
• Utility receipts (should be reported in item A.)
• Amounts received from other governments (should be
reported in 4 )

Sewerage charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Refuse collection, disposal, and recycling charges. . . . . . . . . . .

3.

Parks and recreation charges (e.g., swimming, golf,
auditoriums, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

Airports

Thou.

Dol.

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1.

Other Revenues
$Mil.

Include
• Rentals and gross sales of gas and oil . . . . . . . . . . . . . . . .
5.

Hospital charges
Include
• Amounts received on behalf of individual patients under the
Medicare program or other insurance-type arrangements
Exclude
• Medicaid and the amounts for hospital purposes received
from other governments (should be reported in 4 ) . . . . .

6.

Parking facilities (e.g., lots, garages, meters, etc.) . . . . . . . . . . .

7.

Housing project rentals (gross) . . . . . . . . . . . . . . . . . . . . . . . . . .

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Page 8
PART 2 – REVENUES - Continued
8.

Highways and other roads
Include
• Bridges
• Tunnels
• Ferries

Other Revenues
$Mil.

Thou.

Dol.

(a) Operated on a fee or toll basis . . . . . . . . . . . . . . . . . . . . . .

(b) Other street and highway charges . . . . . . . . . . . . . . . . . . . .

9.

Sea and inland port facilities . . . . . . . . . . . . . . . . . . . . . . . .

10. Miscellaneous commercial activities directly operated by
this government (e.g., cemeteries, cable television,
telephone utilities, rail lines, etc.) . . . . . . . . . . . . . . . . . . . . .
11. Natural resources charges - Sale of minerals and other
natural products from public lands and revenue from
agricultural fairs and shows . . . . . . . . . . . . . . . . . . . . . . . . .
12. Other sales and service revenues - Specify:
➤

Include
• Miscellaneous fee collections

...
C. Special assessments - Compulsory contributions and
reimbursements from owners of property benefited by
improvements (e.g., streets, sewers, sidewalks, water
extensions, etc.) as well as for servicing special
assessment debt.
Exclude
• Proceeds from sales of special assessment bonds
(should be reported in 12 )
• Maintenance assessments (should be reported in item B.). . . . .
D. Receipts from sale of property and other capital assets
Include
• Property sold to other governments
Exclude
• Tax sales (should be reported in 3 ) . . . . . . . . . . . . . . . . . . . .

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Page 9

E.

Interest earnings - Interest received on all deposits and
investment holdings of this government and its agencies.
Include
• Interest on construction funds
Exclude
• Interest earnings of any employee pension funds . . . . . . . . . . .

F.

Other Revenues
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

Fines and forfeits - Receipts from penalties imposed for
violations of law and civil penalties . . . . . . . . . . . . . . . . . . . . . . . . .

G. Rents - Revenues from temporary possession or use of
government-owned buildings, land, and other properties . . . . . . . .
H. Royalties - Compensation or portion of proceeds from
extraction of natural resources (e.g., oil, gas, and
mineral rights) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I.

Private donations - Gifts of cash or securities from
private individuals or corporations . . . . . . . . . . . . . . . . . . . . . . .

J.

Miscellaneous other revenues - Revenues of this government
and its agencies not reported in items A. through I. or questions
3 through 4 .

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PART 2 – REVENUES - Continued

Include
• Insurance claims
• Recoveries of prior year expenditures
• Dividends
• Recorded profits from sale of investments
• Payments in lieu of taxes from private sources
Exclude
• Proceeds from borrowing
• Receipts from sale of security holdings
• Transfers between funds or accounts of this government
• Employee contributions to employee pension funds
• Interest earnings of any employee pension funds
Specify and report miscellaneous revenue:
...

2.

...

3.

...

4.

...

5.

...

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1.

Total Revenues
$Bil.

6

Mil.

Thou.

Dol.

What was the total amount of revenues reported on this
worksheet (Sum of 3 through 5 )?. . . . . . . . . . . . . . . . . . . . . .

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Page 10

7

Were payments made to other governments for services or programs performed on a reimbursement
or cost sharing basis (i.e., intergovernmental expenditures) during the fiscal year indicated in 2 ?
Yes - Go to 8
No - Go to 9

8

What was the amount of intergovernmental expenditures during the fiscal year indicated in 2 ?
To Other Local Governments
$Mil.

Thou.

Dol.

To the State
$Mil.

Thou.

Dol.

A. Streets and
highways . . . . . . . . .

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PART 3 – EXPENDITURES

B. Financial
administration . . . .

C. Central
administration . . . .

D. Fire protection . . . .

Parks and
recreation . . . . . . . .

F.

Solid waste
management . . . . . .

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E.

G. Sewerage. . . . . . . . .

H. Water supply
system . . . . . . . . . . .

I.

Hospitals . . . . . . . . .

J.

Health (other than
hospitals) . . . . . . . . .

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Page 11

To Other Local Governments
$Mil.

Thou.

Dol.

To the State
$Mil.

Thou.

Dol.

K. Police protection . .

L.

Judicial and legal
services . . . . . . . . . .

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PART 3 – EXPENDITURES - Continued

M. Correctional
institutions . . . . . . .

N. Other correctional
activities . . . . . . . . .

O. Libraries. . . . . . . . . .

P. Public welfare. . . . .

Q. Protective
inspection . . . . . . . .

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R. Housing and
community
development . . . . . .
S. Natural resources Flood control, soil and
water conservation,
drainage, irrigation,
forestry and forest fire
protection, agricultural
fairs, and any other
activities for promotion
of agriculture and
conservation of
natural resources. . . .

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Page 12

To Other Local Governments
$Mil.

T.

Thou.

Dol.

To the State
$Mil.

Thou.

Dol.

Airports . . . . . . . . . .

U. Electric supply
system . . . . . . . . . . .

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PART 3 – EXPENDITURES - Continued

V. Parking . . . . . . . . . .

W. Natural gas
supply system . . . . .

X. Transit . . . . . . . . . . .

Y. Sea and inland
port facilities . . . . .

Z.

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Other . . . . . . . . . . . .
Specify: C

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Page 13

9

What was the amount of direct expenditures by purpose and type during the fiscal year indicated in 2 ?
Include
• Expenditures of all funds except those noted in any supplementary instructions with this survey
Exclude
• Transfer between funds or accounts of this government
• Payments made to other governments (should be reported in 8 )
• Benefits and payments from self-administered employee pension plans
Capital Outlays

Current Operation
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services
Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

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PART 3 – EXPENDITURES - Continued

Purchase of equipment,
land, and existing structures
Include capital leases

A. Toll highways - Maintenance, operation, repair, and construction of highways, roads, bridges, ferries, and tunnels
operated on a fee or toll basis.
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

B. Highways - Construction and maintenance of roads, sidewalks and bridges; street lighting; snow removal; highway
engineering, control, and safety.
Exclude
• Street cleaning expenditures (should be reported in item G.)

C. Financial administration - Office of the finance director, auditor, comptroller, treasurer; tax assessment and
collection; central accounting, budgeting, and purchasing services, etc.

E.

Fire - Firefighting and fire prevention.
Include
• Ambulance and paramedic services handled by the fire department
• Contributions of volunteer fire units
Exclude
• Contributions to a local fire pension fund
• Forest fire protection amounts (should be reported in item U.)

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D. Central administration - County or city council, aldermen or commissioners; county, city or town
administrator or manager; clerks office, recorder, planning, zoning, and personnel.

Page 14

Capital Outlays

Current Operation
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services
Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization
F.

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

Purchase of equipment,
land, and existing structures
Include capital leases

Parks and recreation - Playgrounds; golf courses; swimming pools; museums; marinas; community music, drama,
festivals; zoos, and other cultural activities.
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

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PART 3 – EXPENDITURES - Continued

Dol.

G. Solid waste management - Street cleaning and the collection, recycling, and disposal of refuse and garbage.

H. Sewerage - Construction, maintenance, and operation of sanitary and storm sewer systems and sewage disposal
plants.

I.

Water supply system

J.

Hospitals - Construction and operation of hospitals by this government; payments to hospitals operated privately.

Include
• Environmental health activities
• Health regulation and inspection
• Water and air pollution control
• Mosquito control
• Animal control warden
• Inspection of food handling establishments

• Ambulance and paramedic services not part
of a fire department
• Public health nursing
• Vital statistics collection
• All other services performed directly by the
public health department

Exclude
• Payments under public welfare programs (should be reported in item R.)

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K. Health (other than hospitals) - All public health activities; except provision of hospital care.

Page 15

Capital Outlays

Current Operation
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services
Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization
L.

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

Purchase of equipment,
land, and existing structures
Include capital leases

Police - Police agencies for preventing, controlling, or reducing crime; law enforcement activities of sheriff and
constable offices; coroners; medical examiners; vehicular inspection activities; traffic control and safety activities;
lock-up operations.

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PART 3 – EXPENDITURES - Continued

Exclude
• Contributions to a local police pension fund
• Local court activities (should be reported in item M.)
• Local correction activities (should be reported in items N. and/or O.)
$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

M. Judicial and legal - All county or municipal court and court-related activities including juries, probate officials,
prosecutors, bailiffs, marshals, public defenders, attorneys, legal departments, and court activities of sheriffs
departments.
Exclude
• Activities related to probation and parole (should be reported in item O.)

N. Correctional institutions - Construction, maintenance, and operation of correctional facilities, reformatories,
detention facilities, etc., whether for adults or juveniles.
Exclude
• Activities related to probation and parole (should be reported in item O.)

P. General public buildings - Construction, maintenance, and operation of government office buildings not relating
to particular purposes. Report single-purpose buildings (e.g., firehouses, hospitals, etc.) at the purpose specified.

Q. Libraries - Payments to nongovernmental libraries as well as expenditures for libraries operated by this
government.

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O. Other corrections - Activities related to probation and parole, training of corrections officers, nonresidential
halfway houses, and community corrections centers.

Page 16

Current Operation
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services
Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization

Capital Outlays

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

Purchase of equipment,
land, and existing structures
Include capital leases

R. Public welfare - Support of, and assistance to, needy persons, including expenditures from State and Federal grants.

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PART 3 – EXPENDITURES - Continued

Exclude
• Any payments to the State for this government’s share of the welfare costs (should be reported in 8 )
1.
$Mil.

Money paid directly to needy persons covered by Federal aid programs (e.g., Temporary Assistance for
Needy Families).
Thou.

Dol.

2.

Money paid directly to needy persons not covered by Federal aid programs (e.g., general relief, home relief,
poor relief, etc.).

3.

Payments to landlords, utilities, vendors, etc., for rent, goods, and services furnished to needy persons, other
than for medical and hospital care.

4.

Payments to private vendors for medical and hospital care provided to needy persons.

5.

Welfare institutions operated by this government, including nursing homes, veterans’ homes, homes for the
elderly, and indigent care institutions.

6.

Other public welfare - Administration of relief and assistance, foster care, related community action programs,
and other welfare activities not reported in items R1. through R5.

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Exclude
• Payments to hospital or health agencies operated by this government (should be reported in items J.
and/or K.)

Page 17

Capital Outlays

Current Operation
Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services
Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

Purchase of equipment,
land, and existing structures
Include capital leases

S. Protective inspection and regulation - Regulation of private enterprise for the protection of the public and
inspection of hazardous activities (including building inspection), except when related to major functions (e.g.,
health, natural resources, etc.).
$Mil.

T.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

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PART 3 – EXPENDITURES - Continued

Dol.

Housing and community development - Gross expenditures for urban renewal housing projects and
similar activities.

U. Natural resources - Flood control, soil and water conservation, drainage, irrigation, forestry and forest fire
protection, agricultural fairs, and any other activities for promotion of agriculture and conservation of natural
resources.

V. Airports

X. Parking facilities - Garages, parking lots, and all purchases and maintenance of meters, etc.

Y. Gas supply system

Z.

Transit or bus system

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W. Electric power system

Page 18

Current Operation

Capital Outlays

Direct expenditures for employee
compensation and for supplies,
materials, operating leases, and
contractual services

Construction
Include production, additions,
replacements, or major
structural alterations to
buildings and other
improvements

Include gross salaries and
wages before deductions
Exclude capital outlays and
depreciation/amortization
AA.

Purchase of equipment,
land, and existing structures
Include capital leases

Sea and inland port facilities - Docks, wharves, harbors, piers, canals, waterways, and related warehouses.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

BB.

Miscellaneous commercial activities - Directly operated by this government (e.g., cemeteries, cable
television, telephone utilities, rail lines, etc.).

CC.

Interest on debt - Amounts of interest paid, including any interest on short-term or non-guaranteed
obligations as well as general obligations.

Dol.

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PART 3 – EXPENDITURES - Continued

Include
• Capitalized interest paid on construction loans
1. Interest on water supply system debt

Interest on electric power system debt

3.

Interest on gas supply system debt

4.

Interest on transit or bus system debt

5.

Interest on all other debt

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2.

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Worksheet F-28

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Page 19

DD.

All other expenditures - Any amounts which have not been allocated above by purpose.
Include
• Employer contributions to a state administered retirement system or to the Federal Social Security
Administration
• Judgments and insurance premiums
• Government service agencies, such as a central garage or an IT or engineering department, which serves
more than one functional agency, and whose expenses are not allocated to the various departments
• Recorded losses from sale of investments
Exclude
• Payments for retirement of debt
• Payments for purchase of securities
• Transfers between funds or agencies of this government
• Benefits and payments from self-administered employee pension funds
1.

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PART 3 – EXPENDITURES - Continued

Other expenditures - Specify:
(a) Direct expenditures including salaries and wages
Include
• Gross salaries and wages before deductions
Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

(b) Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . .
(c) Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Other expenditures - Specify:
(a) Direct expenditures including salaries and wages
Include
• Gross salaries and wages before deductions
Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .

(c) Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

Other expenditures - Specify:
(a) Direct expenditures including salaries and wages
Include
• Gross salaries and wages before deductions
Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .
(b) Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . .
(c) Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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(b) Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . .

Page 20

4.

Other expenditures - Specify:
(a) Direct expenditures including salaries and wages
Include
• Gross salaries and wages before deductions

$Mil.

Thou.

Dol.

$Mil.

Thou.

Dol.

Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .
(b) Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . .
(c) Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.

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PART 3 – EXPENDITURES - Continued

Other expenditures - Specify:
(a) Direct expenditures including salaries and wages
Include
• Gross salaries and wages before deductions
Exclude
• Capital outlays and depreciation/amortization . . . . . . . . . . .
(b) Construction
Include
• Production, additions, replacements, or major structural
alterations to buildings and other improvements . . . . . . . .
(c) Purchase of equipment, land, and existing structures
Include
• Capital leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Expenditures
10

What was the total amount of expenditures
reported on this worksheet (Sum of 8 through 9 )?. . . . . . .

11

What was the total amount of expenditures for salaries
and wages reported in 9 ?

Mil.

Thou.

Dol.

Personnel Expenditures
$Bil.

Mil.

Thou.

Dol.

Exclude
• Fringe benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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$Bil.

Page 21

12

What was the total amount of long-term debt held by this government for the fiscal year indicated
in 2 ? Report bonds, mortgages, etc., with an original term of more than one year, including revenue bonds
and special assessment bonds as well as general obligation bonds.
Include
• Debt refunded
Exclude
• Capital leases (should be reported in 9 )
• Amounts for compensated absences
A. What was this government’s debt for all public
purposes?

Long-term Debt
for Public Purposes
$Bil.

Mil.

Thou.

Dol.

1. Outstanding at beginning of fiscal year . . . . . . . . . . . . +

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PART 4 – INDEBTEDNESS

2. Issued during fiscal year
(include all refunding issues) . . . . . . . . . . . . . . . . . . . . +
3. Retired during fiscal year
(include debt refunded) . . . . . . . . . . . . . . . . . . . . . . . . 4. Outstanding total at end of fiscal year
(items A1. + A2. - A3.). . . . . . . . . . . . . . . . . . . . . . . . . . =
B. What was this government’s debt for privately owned housing,
industrial, or business purposes? This category is applicable
only to those governments authorized to issue debt of this type
(e.g., industrial development revenue bonds, pollution control
revenue bonds, conduit debt, etc.).
$Bil.

Long-term Debt
for Private Purposes
Mil.

Thou.

Dol.

1. Outstanding at beginning of fiscal year . . . . . . . . . . . . +
2. Issued during fiscal year
(include all refunding issues) . . . . . . . . . . . . . . . . . . . . +
3. Retired during fiscal year
(include debt refunded) . . . . . . . . . . . . . . . . . . . . . . . . -

13

What was the total amount of short-term debt held by this government for the fiscal year indicated
in 2 ? Report 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
• Current portion of long-term debt (should be reported as
long-term debt in 12 )

Short-term Debt
$Bil.

Mil.

Thou.

Dol.

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

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

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4. Outstanding total at end of fiscal year
(items B1. + B2. - B3.). . . . . . . . . . . . . . . . . . . . . . . . . . =

Page 22

14

What was the total amount of cash and investments (at market value) held by this government at the
end of the fiscal year indicated in 2 ?
Include
• 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
Exclude
• Accounts receivable
• Value of real property
• All non-security assets
• Employee retirement funds
Amount at End
of Fiscal Year

A. Reserves held for redemption of long-term debt –
(e.g., sinking or debt service funds).
Include
• Any mortgages and notes receivable held as offsets
to housing and industrial financing loans . . . . . . . . .

$Bil.

Mil.

Thou.

Dol.

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PART 5 – CASH AND INVESTMENTS HELD AT END OF FISCAL YEAR

B. Unexpended proceeds from sale of bond issues
held pending disbursement – (e.g., bond funds) . . . . .
C. All other cash and investments – Checking/savings
accounts, CDs, stocks, bonds, mutual funds, etc. . . . . . . .
PART 6 – REMARKS
15

Use this space for any explanations that may be essential in understanding the reported data.
Include
• Any significant changes occurring within the last year
• Any difficulties encountered in completing this survey

PART 7 – CONTACT INFORMATION
16

Who should be contacted to answer questions about data reported on this survey?

Area code and phone number

Email Address

Title of contact person

Extension

Area code and fax number

Date completed
(MM)
(DD)

(YYYY)

Thank you for completing this survey.
Retain a copy of the completed report for your records.
NOTE: The U.S. Census Bureau receives its authorization to conduct this survey from Title 13, United States Code, Sections 161 and 182. This survey has been approved by the
Office of Management and Budget (OMB) and given the number 0607-0585. Please note the number displayed in the upper right-hand corner of this worksheet. 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(b).
Please note that this is a national survey 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 3 hours to 40 hours per response, with an average of 6 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.

Worksheet F-28

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Name of contact person