Form Pf-1-02 - Survey Of County Board Finances - Department Of Audit Page 2

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REVENUE FROM OTHER GOVERNMENTS: Show all grants,
DIRECT FEDERAL ASSISTANCE
Reimbursements for services, rentals and shared revenues.
_____________________$_________
_____________________$_________
Separate into the proper sections for Federal, State and Local
_____________________$_________
Sources for all revenue received from other governments.
TOTAL REVENUE FROM FEDERAL $_______________
DIRECT LOCAL REVENUE
DIRECT STATE ASSISTANCE
___________________$_____________
____________________$__________
___________________$_____________
____________________$__________
___________________$_____________
____________________$__________
TOTAL FROM LOCAL $____________________
TOTAL FROM STATE $_______________
RECEIPTS FROM SALE OF PROPERTY (Describe)________________________$_____________________
INTEREST EARNINGS
____________________________$____________________
MISCELLANEOUS OTHER INCOME (Describe)____________________________$____________________
____________________________$_____________________
TOTAL REVENUE
all sources
$______________________
PART 2 - EXPENDITURES
EXPENDITURES FOR CONSTRUCTION Include major repairs and alterations,
projects carried out by entity employees and/or by independent contractors.
$________________
PURCHASE OF EQUIPMENT, LAND AND EXISTING STRUCTURES (include
lease/purchase and installment contracts)
$________________
INTEREST ON DEBT include total interest paid on all debt, long term and short
term. Do not enter principal repaid.
$________________
PAYMENTS TO OTHER GOVERNMENTS In lieu of taxes or reimbursements
for goods or services.
TO LOCAL
$________________
TO STATE
$________________
ALL OTHER EXPENDITURES
1. Administration $_________________
2. Operations
$_________________
3. Indirect Costs $_________________
SUBTOTAL OF 1-3
$________________
TOTAL EXPENDITURES
$______________
(all categories)
SALARIES AND WAGES
– Total salaries and wages, including board salaries for construction, paid during fiscal
year to all officers and employees of your entity, including regular, temporary, full-time and part-time personnel. (This
amount will already be included in all the expenditures shown above. Do not subtract it out and change the
numbers above, just show it in addition to the amounts reported.)
$_______________________
For year ended 2016
Page 2
PF-1-02

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