Form Ms-4 - Revised Estimated Revenues Page 2

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NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
MS-4
MUNICIPAL SERVICES DIVISION
PO BOX 487, CONCORD, NH 03302-0487
(603) 271-3397
City/Town:
FY:
REVISED ESTIMATED REVENUES (RSA 21-J:34)
WARR.
For Use By
Reserved For Use
Acct. #
SOURCE OF REVENUE
ART.#
Municipality
by DRA
INTERFUND OPERATING TRANSFERS IN
XXXXXXXXXXX
XXXXXXXXXX
3912
From Special Revenue Funds
3913
From Capital Projects Funds
3914
From Enterprise Funds
Sewer - (Offset)
Water - (Offset)
Electric - (Offset)
Airport - (Offset)
3915
From Capital Reserve Funds
3916
From Trust & Agency Funds
OTHER FINANCING SOURCES
XXXXXXXXXXX
XXXXXXXXXXX
3934
Proc. from Long Term Bonds & Notes
SUBTOTAL OF REVENUES
**General Fund Balance**
For Municipal Use
$
Unreserved Fund Balance
XXXXXXXXXX
XXXXXXXXXXXX
<$
>
Voted From Fund Balance “Surplus”
Unreserved Fund Balance - Retained
<
>
XXXXXXXXXXX
XXXXXXXXXXXX
$
Unreserved Fund Balance - Reduce Taxes
TOTAL REVENUES AND CREDITS
REQUESTED OVERLAY (RSA 76:6)
$
PREPARER’S SIGNATURE AND TITLE
DATE
SUBMIT BY SEPTEMBER 1 TO THE ADDRESS ABOVE
MS-4
2
Rev. 8/00

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