Municipal Governments - Quarterly Survey of Selected Financial Investments and Receipts

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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

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General Information

IMPORTANT: Please read the reporting instructions carefully BEFORE completing the questionnaire.

-1 - Question identifier:i)

Please provide the following contact information:

(a): Mr./Mrs./Miss
(b): First name, last name
(c): Title
(d): Telephone number (000-000-0000)
(e): Facsimile number (000-000-0000)
(f): E-mail address
(g): Date completed (YYYY-MM-DD)

Authority

The collection of this information is authorized by the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19.

COMPLETION OF THIS QUESTIONNAIRE IS A LEGAL REQUIREMENT UNDER THIS ACT.

Confidentiality

Confidential when completed.

Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. The confidentiality provisions of the Statistics Act are not affected by either the Access to Information Act or any other legislation. Therefore, for example, the Canada Revenue Agency cannot access identifiable survey records from Statistics Canada.

Information from this survey will be used for statistical purposes only and will be published in aggregate form only.

Data-sharing agreements

To reduce respondent burden, Statistics Canada has entered into data sharing agreements with provincial and territorial statistical agencies and other government organizations, which must keep the data confidential and use them only for statistical purposes. Statistics Canada will only share data from this survey with those organizations that have demonstrated a requirement to use the data.

Section 11 of the Statistics Act provides for the sharing of information with provincial and territorial statistical agencies that meet certain conditions. These agencies must have the legislative authority to collect the same information, on a mandatory basis, and the legislation must provide substantially the same provisions for confidentiality and penalties for disclosure of confidential information as the Statistics Act. Because these agencies have the legal authority to compel businesses to provide the same information, consent is not requested and businesses may not object to the sharing of the data.

For this survey, there are Section 11 agreements with the provincial and territorial statistical agencies of Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, and the Yukon.

The shared data will be limited to information pertaining to public sector entities located within the jurisdiction of the respective province or territory.

Section 12 of the Statistics Act provides for the sharing of information with federal, provincial or territorial government organizations. Under Section 12, you may refuse to share your information with any of these organizations by writing a letter of objection to the Chief Statistician and returning it with the completed questionnaire. Please specify the organizations with which you do not want to share your data.

For this survey, there are Section 12 agreements with the statistical agencies of Prince Edward Island, the Northwest Territories and Nunavut.

For agreements with provincial and territorial government organizations, the shared data will be limited to information pertaining to public sector entities located within the jurisdiction of the respective province or territory.

Record linkage

To enhance the data from this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.

Return procedures

Please return one completed form by the 15th of the month following the period under review to:

Statistics Canada
170 Tunney's Pasture Driveway
Operations and Integration Division,
JT2-B15
Ottawa, Ontario, K1A 0T6

Retain one completed form for your records. Please return the questionnaire in the enclosed envelope.

Assistance

If any questions should arise regarding the completion of this form, please do not hesitate to call the Institutional Statistics Section at (866) 351-2587. Facsimile (613) 951-0709 / (800) 755-5514, (E-mail piu/uip@statcan.gc.ca).

Thank you

Thank you very much for your cooperation.

Reporting Period Information

Reporting Period Information - Question identifier:1.

Please indicate the quarter for this reporting period:

1: January 1 to March 31 (first quarter)
2: April 1 to June 30 (second quarter)
3: July 1 to September 30 (third quarter)
4: October 1 to December 31 (fourth quarter)

Reporting Period Information - Question identifier:2.

Please indicate the year for this reporting period.

I. Selected Financial Assets

CASH ON HAND AND ON DEPOSIT (REFERENCE 31000)

I. Selected Financial Assets - Question identifier:1.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in the Municipal General Revenue Funds for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:2.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in the Municipal General Capital and Loan Fund for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:3.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in the Municipal Sinking Fund(s) for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:4.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in the Municipal Reserve and other funds for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:5.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in the Waterworks Funds of Own Agencies (combined) for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:6.

Please report in dollars (omit cents), Cash on Hand and on Deposit (Reference 31000) in Other Funds (specify) of Own Agencies (combined) for the following:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

I. Selected Financial Assets - Question identifier:7.

Please report in dollars (omit cents), the total (combined) amounts from questions 1 to 6, of Cash on Hand and on Deposit for the following references:

a): Canadian currency only - Cash on hand and in chartered banks (Reference 31100 to 31200)
b): Canadian currency only - Cash in other financial institutions (Reference 31300)
c): Foreign currencies including swapped deposits (Reference 31910 to 31930)
d): Total (combined) cash from items a) to c)

INVESTMENTS (REFERENCE 33000)

I. Selected Financial Assets - Question identifier:8.

Please report in dollars (omit cents), Investments (Reference 33000) in the Municipal General Revenue Funds for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:9.

Please report in dollars (omit cents), Investments (Reference 33000) in the Municipal General Capital and Loan Fund for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:10.

Please report in dollars (omit cents), Investments (Reference 33000) in the Municipal Sinking Fund(s) for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:11.

Please report in dollars (omit cents), Investments (Reference 33000) in the Municipal Reserve and other funds for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:12.

Please report in dollars (omit cents), Investments (Reference 33000) in the Waterworks Funds of Own Agencies (combined) for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:13.

Please report in dollars (omit cents), Investments (Reference 33000) in Other Funds (specify) of Own Agencies (combined) for the following:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

I. Selected Financial Assets - Question identifier:14.

Please report in dollars (omit cents), the total (combined) amounts from questions 8 to 13, of Investments (Reference 33000) for the following references:

a): Federal government and its agencies - Treasury bills (Reference 33110)
b): Federal government and its agencies - Bonds (Reference 33120 to 33160)
c): Provincial or territorial governments and their agencies - Treasury bills (Reference 33210)
d): Provincial or territorial governments and their agencies - Bonds (Reference 33220 to 33260)
e): Other local governments and their agencies - Debentures (Reference 33430 to 33440)
f): Own municipality (where permitted) - Debentures (Reference 33530 to 33540)
g): Finance and short term paper (marketable short term notes and bankers' acceptances) (Reference 33710 to 33730)
h): Other investments (residual of 33000 - please specify major items)
i): Total (combined) investments from items a) to h)

LENDING: (Assets) (REFERENCE 34000)

I. Selected Financial Assets - Question identifier:15.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in the Municipal General Revenue Funds for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:16.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in the Municipal General Capital and Loan Fund for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:17.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in the Municipal Sinking Fund(s) for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:18.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in the Municipal Reserve and other funds for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:19.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in your Waterworks Funds of Own Agencies for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:20.

Please report in dollars (omit cents), Lending (Assets - Reference 34000) in your Other Funds (specify) of Own Agencies (combined) for the following:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

I. Selected Financial Assets - Question identifier:21.

Please report in dollars (omit cents), the total (combined) amounts from questions 15 to 20, of Lending (Assets - Reference 34000) for the following references:

a): To own enterprises (hydro, gas, telephone and transit systems) (Reference 34120)
b): Other lending (residual of 34000 - please exclude interfunds and specify major items)
c): Total (combined) lending from items a) and b)

II. Selected Municipal Receipts (cash basis - see the following instructions)

II. Selected Municipal Receipts (cash basis - see the following instructions) - Question identifier:22.

For the current quarter please report Local Government Tax Collections (Reference 11000 + 19800) for the following:

a): Collections for own municipal purposes
b): Collections on behalf of other local governments
c): Collections on behalf of local school authorities
d): Collections on behalf of provincial or territorial government

II. Selected Municipal Receipts (cash basis - see the following instructions) - Question identifier:23.

For the current quarter please report total conditional and unconditional transfers from your provincial government (current and capital) (Reference 16200 + 17500).

II. Selected Municipal Receipts (cash basis - see the following instructions) - Question identifier:24.

For year to date please report Local Government Tax Collections (Reference 11000 + 19800) for the following:

a): Collections for own municipal purposes
b): Collections on behalf of other local governments
c): Collections on behalf of local school authorities
d): Collections on behalf of provincial or territorial government

II. Selected Municipal Receipts (cash basis - see the following instructions) - Question identifier:25.

For year to date please report total conditional and unconditional transfers from your provincial government (current and capital) (Reference 16200 + 17500).

Date modified:: 2019-04-18

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