Form 4408LGF "Quarterly Economic Survey" - Nevada

What Is Form 4408LGF?

This is a legal form that was released by the Nevada Department of Public Safety - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 31, 2016;
  • The latest edition provided by the Nevada Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 4408LGF by clicking the link below or browse more documents and templates provided by the Nevada Department of Public Safety.

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Form 4408LGF
QUARTERLY ECONOMIC SURVEY
_______________________________________________________________________________
QUARTER ENDING: _______________
ENTITY __________________________________
DATE PREPARED: ________________
Pursuant to NRS 354.6015 and NAC 354.559 local governments are required to submit a quarterly survey report.
QUESTIONS REGARDING ECONOMIC CONDITIONS
Yes
No
Since the last filing:
Has any employer that accounts for 15% or more of the employment in the area closed or signi-
1
ficantly reduced operations since the previous report? If yes, please provide details on page 2.
2
Has your entity experienced a cumulative increase or decrease of 10% or more in population or
assessed valuation in the past two years? If yes, please provide details on page 2.
3
Has there been any significant event(s) in the region which could affect your entity positively?
If yes, please provide details on page 2.
4
Has there been any significant event(s) in the region which could affect your entity negatively?
If yes, please provide details on page 2.
5
Has anything significant occurred which could affect your expected level of revenues?
If yes, please provide details on page 2.
QUESTIONS REGARDING OPERATIONS
Has the ending fund balance in your general (principal operating) fund had an unexplained,
6
unbudgeted or unanticipated decline for the past two fiscal years? If yes, please provide details on
page 2.
7
Has the entity entered into any new debt arrangements since the previous report?
If yes, please provide details on page 2.
Has the entity borrowed money to pay for current operations?
8
If yes, please provide details on page 2.
Has the entity made an interfund loan(s) to pay for current operations?
9
If yes, please provide details on page 2.
Has the entity failed to pay timely any contributions to governmental agencies for the benefit of its
10
employees (for example, PERS, Workmen’s Comp or Federal taxes)?
If yes, please provide details on page 2.
Has the entity failed to make timely payments for debt service, to vendors or others?
11
If yes, please provide details on page 2.
Has the entity augmented the appropriated expenses for any proprietary fund since the previous
12
report? If yes, please provide details on page 2.
13 Cash and cash equivalents (unaudited) as of quarter ending ______________:
(Enterprise Fund(s) Only)
Prior Year
Current Year
______________
______________
14 General Fund Ending Balance (unaudited) as of quarter ending: _______________:
Prior Year
Current Year
______________
______________
15 Cash and cash equivalents (unaudited) as of quarter ending ______________:
(General Fund Only)
Prior Year
Current Year
______________
______________
4408LGF
Last Revised 01/31/2016
Page 1
Form 4408LGF
QUARTERLY ECONOMIC SURVEY
_______________________________________________________________________________
QUARTER ENDING: _______________
ENTITY __________________________________
DATE PREPARED: ________________
Pursuant to NRS 354.6015 and NAC 354.559 local governments are required to submit a quarterly survey report.
QUESTIONS REGARDING ECONOMIC CONDITIONS
Yes
No
Since the last filing:
Has any employer that accounts for 15% or more of the employment in the area closed or signi-
1
ficantly reduced operations since the previous report? If yes, please provide details on page 2.
2
Has your entity experienced a cumulative increase or decrease of 10% or more in population or
assessed valuation in the past two years? If yes, please provide details on page 2.
3
Has there been any significant event(s) in the region which could affect your entity positively?
If yes, please provide details on page 2.
4
Has there been any significant event(s) in the region which could affect your entity negatively?
If yes, please provide details on page 2.
5
Has anything significant occurred which could affect your expected level of revenues?
If yes, please provide details on page 2.
QUESTIONS REGARDING OPERATIONS
Has the ending fund balance in your general (principal operating) fund had an unexplained,
6
unbudgeted or unanticipated decline for the past two fiscal years? If yes, please provide details on
page 2.
7
Has the entity entered into any new debt arrangements since the previous report?
If yes, please provide details on page 2.
Has the entity borrowed money to pay for current operations?
8
If yes, please provide details on page 2.
Has the entity made an interfund loan(s) to pay for current operations?
9
If yes, please provide details on page 2.
Has the entity failed to pay timely any contributions to governmental agencies for the benefit of its
10
employees (for example, PERS, Workmen’s Comp or Federal taxes)?
If yes, please provide details on page 2.
Has the entity failed to make timely payments for debt service, to vendors or others?
11
If yes, please provide details on page 2.
Has the entity augmented the appropriated expenses for any proprietary fund since the previous
12
report? If yes, please provide details on page 2.
13 Cash and cash equivalents (unaudited) as of quarter ending ______________:
(Enterprise Fund(s) Only)
Prior Year
Current Year
______________
______________
14 General Fund Ending Balance (unaudited) as of quarter ending: _______________:
Prior Year
Current Year
______________
______________
15 Cash and cash equivalents (unaudited) as of quarter ending ______________:
(General Fund Only)
Prior Year
Current Year
______________
______________
4408LGF
Last Revised 01/31/2016
Page 1
Form 4408LGF
QUARTERLY ECONOMIC SURVEY
_______________________________________________________________________________
DETAILS OF POSITIVE RESPONSES TO QUESTIONS ON PAGE 1
QUESTION
1- 6.
7.
Date: _____________
Type: __________________________
Amount: $_____________________
Date: _____________
Type: __________________________
Amount: $_____________________
8.
Date: _____________
Lender: __________________________
Amount: $_____________________
Date: _____________
Lender: __________________________
Amount: $_____________________
9.
Date: _________ From Fund: _______________
To Fund: _______________
Amount: $__________
Date: _________ From Fund: _______________
To Fund: _______________
Amount: $__________
10-11.
12.
Date: _____________
Fund: __________________________
Amount: $_____________________
Date: _____________
Fund: __________________________
Amount: $_____________________
13-15.
------------------------------------------------------------------------------------------------------------------------------------------------
PREPARED BY: ___________________________________
______________________________________
Name/Title
Signature
PERSON SIGNING CERTIFIES ALL INFORMATION PROVIDED IS TRUE & CORRECT FOR PERIOD
INDICATED.
REVIEWED BY: ___________________________________
______________________________________
Name/Title
Signature
The Survey can be submitted to the Department of Taxation electronically via e-mail to the Budget Analyst responsible
for the entity. Please submit in PDF form so as to reflect signatures. This submission will fulfill filing requirements.
4408LGF
Last Revised 01/31/2016
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