Form Pf-1-02 - Survey Of County Board Finances - Department Of Audit

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Return to:
Survey of County Board Finances
Department of Audit
Public Funds Division
For the Fiscal Year Ending June 30, 2016
Herschler Building, 4 West
Cheyenne, WY 82002
County of _________________, Wyoming
This form is #PF-1-02 for the Wyoming Department of Audit, Public Funds Division, which annually
requests certain kinds of data from local governmental boards. Your board is required to complete and
file this form per the Department of Audit’s Rules on file at the Secretary of State’s office. This form is
to be completed and returned to our office by September 30, 2016.
(Please correct your address here , if necessary)
General Instructions: - Please read carefully each part and all related definitions and instructions.
Note especially the following:
1.
Report data from your entity’s fiscal year.
2.
Do not report bank transfers, or interfund transactions as Revenue or Expenditures. Report all interest earned
on investments (include interest on cash deposits), all tax or assessments collected through the county.
Report entity billings in the Current Charges section, and all payments for goods or services provided.
3.
It is not necessary to have audited numbers, unless you expect there would be a material difference from your
records.
4.
Information gathered may be classified as to type, summarized and reported to interested organizations. It
may also be used in fiscal analysis and for statistical purposes. Please make sure it is as accurate as
possible.
PART I - REVENUE
CURRENT CHARGES: Receipts from sales, rentals, fees or other charges for services.
Do not report loans or bonded debt in this section. (Use part 3)
Description ________________________________________$___________
Description ________________________________________$___________
Description ________________________________________$___________
Description ________________________________________$___________
TOTAL CURRENT CHARGES
$____________
PROPERTY TAXES AND ASSESSMENTS: List all taxes and assessments on property measured by value or benefit
and collected for you by another government. Include penalties interest, and past due amounts.
Property taxes (based on value)
$___________
Assessments (for construction projects or repairs)
$___________
Other taxes (please describe)______________________
$___________
Other taxes (please describe)______________________
$___________
Other taxes (please describe)______________________
$___________
TOTAL TAXES AND ASSESSMENTS $___________
PART 1 REVENUE (Continued)
For year ended 2016
Page 1
PF-1-02

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