Title 2 Department of Audit and Control - Appendices - Appendix 8


Published: 2021-01-31

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Form A.C., 973 (1964 Rev.)

Cities under 125,000 population

Counties

Towns

Villages

DEBT STATEMENT

OF

Name of Municipality

___________ COUNTY, NEW YORK

PREPARED AS OF

______, 19 _

Form A.C. 973-1

Cities under 125,000 population

Counties

Towns

Villages

STATE OF NEW YORK

DEPARTMENT OF AUDIT AND CONTROL

DIVISION OF MUNICIPAL AFFAIRS

This is the official debt statement form prescribed for use by counties, towns, villages and cities having a population of less than 125,000 inhabitants according to the 1960 federal census.

ARTHUR LEVITT

State Comptroller

INSTRUCTIONS

1. Statutory Reference. At each Item of indebtedness to be included and excluded in the debt statement will be found a statutory reference. For example, "135.00(a, 1)" means "subdivision 1 of paragraph a of section 135.00 of the Local Finance Law". Reference to that section in the Local Finance Law will show the statutory meaning of the word "Borrowings". Wherever a reference appears, that section of the Local Finance Law should be consulted.

2. Date of Preparation. The statement must be prepared as of a date not more than thirty days previous to the date of sale of bonds. Local Finance Law, section 109.00.

3. Filing. A debt statement must be filed not more than fifteen days nor less than three days before a municipality sells any bonds which are required to be sold at public sale. The statement must be filed with the State Comptroller and a duplicate copy must be filed with the clerk or corresponding officer of the municipality. It is not necessary to file a copy in the county clerk's office. Local Finance Law, section 109.00.

4. Fees for Copies. Should it be necessary to obtain either a copy, certified copy, or exemplified copy of a debt statement filed with the State Comptroller, see paragraph c of section 141.00 of the Local Finance Law, as added by Chapter 437 of the Laws of 1947, for fee schedule. The statute requires such fees to be prepaid.

5. Average Full Valuation. In computing "Average Full Valuation" at page 4, use last completed assessment roll and four preceding rolls. A completed assessment roll is one which has been completed, verified and filed by the assessors and for which a State equalization rate has been established. The words "For Fiscal Year Ending" refer to the year for which taxes have been or will be extended on the assessment roll rather than the year in which the roll was completed. The amounts to be used in Column 1 would be the amounts shown on such rolls as filed after the hearing of grievances, regardless of subsequent changes. In Column 1, include the assessed valuations of special franchises but exclude the assessed valuations of all exempt properties to the extent they are exempt from general taxation. Full valuation (Column 3) is determined as follows: Divide the assessed valuations (Column 1) by the equalization rate (Column 2) established by the State for such valuation. Where boundary changes have occurred and in the case of newly-created municipalities, see section 2.00(7-a) of the Local Finance Law.

In the case of counties, average full valuation is computed by dividing the assessed valuations on the last completed and four preceding assessment rolls of the cities and towns therein by the equalization rates established for such rolls; provided, however, in a county having a county department of assessment the State equalization rates established for the cities and towns therein on the basis of the county roll shall be applied to the apportionate portions of the county roll. The sum of the quotients thus obtained shall be divided by five.

6. INCLUSIONS:

Re Item 8, Page 4. Include the respective amounts of all several indebtedness and allocated or apportioned joint indebtedness contracted or incurred pursuant to Article II, Title 1-A of the Local Finance Law in relation to a joint service or a joint water, sewage or drainage project. The amount of joint indebtedness to be so included should not exceed the amount of such indebtedness allocated and apportioned to the municipality in the bond or note resolution authorizing such indebtedness to be contracted.

(Page 1)

Form A.C. 973-2

Joint indebtedness to be included arising out of real property liabilities and contract liabilities should not exceed the amount of such indebtedness required to be allocated and apportioned to the municipality in the agreement of the participating municipalities in relation to such joint service or project. Where the agreement does not provide for any such allocation or apportionment, or in the case of involuntary joint indebtedness, the amount to be allocated and apportioned and included in the debt statement of a participating municipality should be in the same proportion as the full valuation of the real estate subject to taxation or assessment by such municipality for such joint service or project bears to the full valuation of the real estate subject to taxation or assessment by all of the participating municipalities for such joint service or project. See Local Finance Law, section 15.10. However, if the State Comptroller has issued a certificate allocating and apportioning such joint indebtedness pursuant to the provisions of section 15.10 of the Local Finance Law, the amounts so allocated and apportioned by the State Comptroller should be included in the debt statements of each respective municipality as indebtedness.

7. EXCLUSIONS:

(a) Item 1, Page 5. Do not include bonds, bond anticipation notes, capital notes, budget notes or obligations which have been issued for the direct financing of improvement or equipment. Do not include any tax or revenue obligations, or renewals thereof, which have not been retired within five years after the date such original obligations were issued.

(b) Item 2, Page 5. Include only obligations issued for objects or purposes other than the financing of capital improvements and contracted to be redeemed in one of the two fiscal years immediately succeeding the year of their issue, Do not include serial bonds of an issue having a maximum maturity of more than two years.

(c) Item 3, Page 5. Do not include joint or several indebtedness contracted pursuant to Article II, Title 1-A of the Local Finance Law to finance a joint water project. Such indebtedness is to be included in Item 12, page 5.

(d) Item 4, Page 5. Do not include any indebtedness contracted pursuant to Article II, Title 1-A of the Local Finance Law in relation to a joint service or a joint water, sewage or drainage project.

(e) Item 11, Page 5. Include city indebtedness for education purposes, if any, allocated to the city school district by the State Comptroller pursuant to section 1 of Chapter 831 of the Laws of 1951.

(f) Item 12, Page 5. State the respective amounts of any several indebtedness and the allocated or apportioned amounts of any joint indebtedness contracted or incurred in relation to the financing of a joint water project pursuant to Article II, Title 1-A of the Local Finance Law.

(g) Items 13 and 14, Page 5. State the respective amounts of any several indebtedness and the allocated or apportioned amounts of any joint indebtedness contracted or incurred in relation to the financing of a joint service and a joint sewage or drainage project pursuant to Article II, Title 1-A of the Local Finance Law and excluded pursuant to the provisions of sections 15.20 and 123.00 of such law.

8. Gross Joint Indebtedness. The aggregate gross amount of all joint indebtedness including borrowings, real property liabilities, contract liabilities, judgments, claims, awards and determinations contracted or incurred and before any apportionment or allocation should be stated at page 4 of the debt statement.

* * *

* *

*

(Page 2)

Form A.C. 973-3

The following is a statement of the __ of __ in the County of __, New York, to contract indebtedness, and is prepared as of __, 196 , pursuant to Title 8, Article II of the Local Finance Law.

DEBT LIMIT

Counties (except Nassau), cities, towns and villages   $ __

Multiply "Average Full Valuations" (Page 4) by.07

(Nassau County.10)

TOTAL NET INDEBTEDNESS

Total Inclusions (Page 4)   $__

Less: Total Exclusions (Page 5)   __

Total Net Indebtedness   $__

__

NET DEBT-CONTRACTING MARGIN

Debt Limit (Above)   $__

Less: Total Net Indebtedness (Above)   __

Net Debt-Contracting Margin   $__

__

PERCENTAGE OF DEBT-CONTRACTING POWER EXHAUSTED

Divide "Total Net Indebtedness" by "Debt Limit" and

enter result here   __

PROPOSED BOND ISSUE

The amount of bonds proposed to be sold at public sale

on __, 196 , in connection with

which this statement is made and filed is   $ __

The amount of bond anticipation notes heretofore issued

in anticipation of the sale and issuance of such bonds

and included at "Borrowings" at Item 1 of Inclusions at

page 4 is   $__

The municipality will not sell any bonds or notes at public

or private sale between the date as of which this debt

statement is prepared and the date of sale above mentioned

except as follows:

(Page 3)

Form A.C. 973-4

STATEMENT OF TOTAL DEBT

AVERAGE FULL VALUATION

NOTE: See Instruction 5, Page 1.

INCLUSIONS

1. Borrowings. 135.00(a, 1).   $____

2. Real Property Liabilities. 135.00(a, 2), 142.00.   ______

3. Contract Liabilities. (Separate according to 135.00(a,   3)).   (a)____

(b)____

4. Cities, Towns and Villages:  Contract Liabilities:  Housing Guarantees; Subsidies.   (a)____ (Separate according to 135.00(a, 4)).   (b)____

5. Cities, Towns and Villages:  State Loans to Certain Housing Authorities and Mu-  nicipalites. 135.00(a, 5).    ____

6. Judgments, Claims, Awards and Determinations   (a)____ (Separate according to 135.00(a, 6))   (b)____

7. Cities, Towns and Villages:  Indebtedness Contracted by Certain District Corpora-  tions. 135.00(a, 7)    ____

8. Indebtedness Contracted or Incurred Pursuant to  Article II, Title I-A of the Local Finance Law in  relation to a Joint Service or Joint Water, Sewage or  Drainage Project: (See Instruction 6, Page 1.)  (a) Borrowings: Several Indebtedness.    ____ (b) Borrowings: Allocated or Apportioned Joint  Indebtedness.    ____ (c) Real Property Liabilities.    ____ (d) Contract Liabilities.    ____ (e) Judgments, Claims. Awards and Determinations. ____ Total Inclusions   $ ____

____

GROSS JOINT INDEBTEDNESS

The aggregate gross amount of all joint indebtedness  before apportionment or allocation i  $____ (See Instruction 8, page 2.) 

____

(Page 4)

Form A.C. 973-5

STATEMENT OF TOTAL DEBT

(Continued)

EXCLUSIONS

1. Tax and Revenue Obligations. 136.00(1).   $____ (See Instruction 7(a), page 2.)

2. Obligations Issued for other than Capital Improve-  ments. 136.00(1-a)   ____ (See Instruction 7(b), page 2.)

3. Water Indebtedness. 136.00(2).   $____ (See Instruction 7(c), page 2.)

4. Indebtedness Contracted for Self-Liquidating Proj-  ects. 136.00(3).   (a) ____ (See Instruction 7(d), page 2.) (b)____

(c)__

5. Sewer Indebtedness Contracted on or after January  1, 1962, and prior to January 1, 1973. 136.00(4-a).   ____

6. Bonds for Pensions. 136.00(4).    ____

7. Cities and Villages with Population of 5,000 or More:   Indebtedness for Housing and Urban Renewal Purposes.   (a)____ (Separate according to 136.00(8)). (b)____

(c)____

(d)____

8. Towns and Villages with Population of Less than  5,000: Subsidies or Guarantees for Housing Purposes.  136.00(9).   ____

9. Assets of Sinking Funds. 136.00(10).    ____

10. Cash on Hand for Debts. 136.00(11).    ____

11. Appropriations. 136.00(12).    ____

12. Cities Only: School Indebtedness. 136.00(13)    ____ (See Instruction 7(e), page 2.)

13. (a) Several Indebtedness Contracted in relation to a  Joint Water Project. 15.20.   (a) ____

 (b) Joint Indebtedness Contracted for such Purpose.  (b)____ (See Instruction 7(f), page 2.)

14. (a) Several Indebtedness Contracted for a Joint  Service and Excluded Pursuant to Local Finance  Law, sections 15.20 and 123.00.   (a)____

 (b) The Apportioned or Allocated Amount of any   such Joint Indebtedness so Excluded.   (b)____ (See Instruction 7(g), page 2.)

15. (a) Several Indebtedness Contracted for a Joint Sewage or Drainage Project and Excluded Pur- suant to Local Finance Law, sections 15.20 and 123.00.   (a)____

 (b) The Apportioned or Allocated Amount of any such Joint Indebtedness so Excluded.   (b)____ (See Instruction 7(g), page 2.)

 Total Exclusions   $____.

____

Form A.C. 973-7

NOTE: This debt statement must be verified by the chief fiscal officer of the municipality. See definition of the term "chief fiscal officer" in the Local Finance Law, section 2.00(5). If a municipality has no chief fiscal officer, then this statement must be verified by the finance board.

VERIFICATION BY CHIEF FISCAL OFFICER

State of New York )

 ) ss:

County of_____)

____ being duly sworn, deposes and says: That _he is the duly (elected) (appointed), qualified, and acting chief fiscal officer of the ____ in the County of ____ New York; that _he prepared and has read the foregoing debt statement and knows the contents thereof; that the same is true to (his) (her) own knowledge except as to the matters therein stated to be alleged upon information and belief, and that as to those matters _he believes it to be true.

Subscribed and sworn to before me  Signature

this _ day of __, 19 _.   Title

Notary Public  Mail Address

VERIFICATION BY FINANCE BOARD

Not necessary if verification is made by chief fiscal officer

State of New York  )

 ) ss:

County of ______)

 

 

being each duly sworn, depose and say: That they are the duly (elected) (appointed), qualified, and acting members of the finance board of the __ in the County of __, New York, that they prepared and each of them has read the foregoing debt statement and knows the contents thereof; that the same is true of their own knowledge except as to the matters therein stated to be alleged upon information and belief, and that as to those matters they believe it to be true.

Subscribed and sworn to before me ___________

this _ day of __, 19 _. ___________

Notary Public ___________

 ___________