F-73 Quarterly Survey of Selected Non-Property Taxes

Attachment 2
U.S. DEPARTMENT OF COMMERCE
U.S. CENSUS BUREAU
WORKSHEET

F-73

QUARTERLY SURVEY OF
SELECTED NON-PROPERTY TAXES

(10-06-2020)

OMB No. 0607-0112: Approval Expires 08/31/2022

DUE DATE:
Survey Questions
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.
Please view the online report for specific instructions that may apply to your organization.
Return to https://portal.census.gov when you are ready to report online.
Need help or have
questions?

• Visit

https://portal.census.gov
• Call
1-800-832-2839 weekdays,
8AM to 5PM ET
• Email
[email protected]

ATTN:

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

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Due 30 days after
the quarter ended

-

REPORT ONLINE: It’s fast and secure. Respond to this survey via the Internet
at the following Web address using the supplied Authentication Code:

https://portal.census.gov

GENERAL INSTRUCTIONS

Before filling out this worksheet, please read carefully each part and all related definitions and instructions.
Note especially:
1.

1

Is the addressee title/department and mailing address the same as shown in the letter?

3.
4.

Yes – Go to 2

No – Enter correct information below

Addressee Title or Department

ATTN:
Street

City

State

Zip Code

Please continue on the next page

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5.

Report figures for the calendar quarter named in the worksheet title.
You may report on either a cash or accrual basis.
Do not delay reporting to await final figures, if reasonable estimates can be supplied on a preliminary basis.
PLEASE COMPLETE ALL ITEMS ON THE WORKSHEET. If some items do not apply to this government, enter
zero ("0") and specify those items as "not applicable" in (3) REMARKS.
To report revisions to any of the prior seven quarters, call 1-800-832-2839.

2.

Page 2

What was the amount of tax collections for the following selected taxes imposed by this government
for the quarter ending
Report zero for any item that has no collection for this quarter.
Include
• Collections during the quarter from all levies for all funds of this government and its agencies
• Taxes collected for this government by another government or authorized agency
• Current and delinquent amounts, penalties, and interest
Exclude
• Any taxes collected on behalf of other governments
• Shares of taxes imposed by another government

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2

Attachment 2

A. General sales and gross receipts taxes
Include
• Sales and use taxes
• 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
• 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 . . . . . . . . . . .

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

$Bil.

Mil.

Thou.

Dol.

B. Local individual income taxes

C. Local corporation net income taxes
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 . . . . . . . . . . . . . . . . . . . . . . .

Worksheet F-73

Please continue on the next page

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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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Attachment 2

3

Use this space for any explanations that may be essential in understanding the reported data.

Who should be contacted to answer questions about data reported on this worksheet?
Name of contact person

Area code and phone number

Email Address

Title of contact person

Extension

Area code and fax number

(MM)

Date completed
(DD)
(YYYY)

Thank you for completing this survey.
Retain a copy of the completed survey 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 0607-0112. 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 survey compiled from or customarily provided in public records are exempt from confidential treatment as cited in Title 13, United States Code,
Section 9. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

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 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.

Worksheet F-73

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4

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Include
• Any significant changes occurring within the last quarter
• Any difficulties encountered in completing this worksheet
• Identify and list all items that are "not applicable" for this government