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u : Transitional Aid Application for Application Years CY 2010/SFY 2011
Division of Local Government Services
Department of Community Affairs
General Instructions: This application must be submitted in its entirety by July 16 (for CY 2010) and September 30 (for SFY 2011) for funding consideration under this program. Information contained in the application is subject to independent verification by DLGS. Refer to Local Finance Notice 2010-14 when preparing this application for specific instructions and definitions.
Name of Municipality:County:Contact Person:Title:Phone:Fax:E-mail:Population:I. Aid History
List amount of Discretionary Aid (Extraordinary, Special Municipal, or Capital Cities) received for the last three years, if any:
Prior YearPrevious YearPrevious less one year$$$II. Aid Request for Application Year
Amount of aid requested for the Application Year:$An aid request does not constitute guarantee of receipt of any funds.
III. Submission Requirements
Without exception, the following items must be submitted with or prior to submission of this application. Indicate date of submission of each.
ItemDate Submitted to DLGSPrior Year Annual Financial StatementPrevious Year Annual AuditPrevious Year Audit Corrective Action PlanApplication Year Introduced BudgetBudget documentation submitted to governing bodyIV. Application Certification
The undersigned herewith certify that they have reviewed this application and, to the best of their ability, find its contents to be true and that it accurately portrays the circumstances regarding the municipality's fiscal practices and need for financial assistance. By submitting the application, the municipality acknowledges that the law provides that the decision of the Director regarding aid awards is final and not subject to appeal.
OfficialSignatureDateMayor/Chief Executive OfficerGoverning Body Presiding OfficerChief Financial Officer V-A. Explanation of Need for Transitional Aid
Explain the circumstances that require the need for Transitional Aid in narrative form. Include factors that result in a constrained ability to raise sufficient revenues to meet budgetary requirements, and if such revenues were raised, how it would substantially jeopardize the fiscal integrity of the municipality. (See item B-5 in Local Finance Notice 2010-14 for details)
VB Alternate Eligibility Calculation
Complete this section only if Discretionary aid was not received in the prior year. If the requirements of this section are met, this application must also reflect that the criteria in Section B, items 2-7 of Local Finance Notice 2010-14 are met.
Part 1 calculates loss of equalized value. If there is a loss of 2% of equalized value, the eligibility criteria is met and the rest of the form does not have to be completed.
If 2% the criteria is not met, continue with Part 2 to identify individual revenue losses (exclusive of State CMPTRA/ETR formula aid reductions) or specific, extraordinary appropriation increases (pursuant to Local Finance Notice 2010-14, Item B-8).
Part 1 Eligibility of Value LossCurrent Year County Equalization Table County Apportionment
(a)Prior Year Directors Table Equalized Value
(b)Decrease
(c)Equalized Value Reduction Percent of loss from prior year (c) divided by (b) as percent:
If this exceeds 2%, stop and proceed to the next page.
Part 2 Demonstration of Revenue Loss/Substantial Cost Increase
Complete Part 2 if eligibility was not met in Part 1. Show extraordinary revenue losses (exclusive of State CMPTRA/ETR aid reductions), but not as the aggregate of many revenue line items; or specific, extraordinary appropriations. Describe the item on the cell below each entry.Revenue or AppropriationPrior Year ValueCurrent Year ValueAmount of Loss/IncreaseDescription:Description:Description:Description:Description:Description:Description:
V-C Actions to reduce future need for aid
Detail the steps the municipality is taking to reduce the need for aid in the future. Include details about long-term cost cutting and enhanced revenue plans, impact of new development, potential for grants to offset costs, and estimated short and long-term annual savings. Use additional pages if necessary.
VI. Historical Fiscal Statistics
ItemActual
Previous YearActual
Prior YearIntroduced
Application Year1. Property Tax/Budget InformationMunicipal tax rate$$$Municipal Purposes tax levy$$$Municipal Open Space tax levy$$$Total general appropriations$$$3. Cash Status Information% Of current taxes collected%%%% Used in computation of reserve%%%Reserve for uncollected taxes$$$Total year end cash surplus$$Total non-cash surplus$$Year end deferred charges$$4. Assessment DataAssessed value (as of 7/1)$$$Average Residential Assessment$$$Number of tax appeals grantedAmount budgeted for tax appeals$$$Refunding bonds for tax appeals$$$5. Full time Staffing LevelsUniformed Police - Staff Number Total S&W Expenditures$$$Uniformed Fire - Staff Number Total S&W Expenditures$$$All Other Employees - Staff Number Total S&W Expenditures$$$6. Impact of Proposed Tax Levy
AmountCurrent Year Taxable ValueIntroduced Tax LevyProposed Municipal Tax RateAverage Res. Value ( #4 above)Current Year Taxes on Average Residential Value (#4 above)Prior Year Taxes on Average Residential ValueProposed Increase in average residential taxes VII. Application Year Budget Information
A. Year of latest revaluation/reassessment
B. Proposed Budget Appropriation and Levy Cap Information
ItemYesNo 1.Was an appropriation cap index rate ordinance adopted last year? If YES: % that was used% 2.Amount of appropriation cap bank available going into this year$ 3.Is the Application Year budget at (appropriation) cap? If NO, amount of remaining balance $ 4.Does the Application Year anticipate use of a waiver to exceed the levy cap? If YES, amount: $
List the five largest item appropriation increases:
AppropriationPrior Year ActualApplication Year Proposed$ Amount of Increase
List all new property tax funded full-time positions planned in the Application Year:
Department/AgencyPositionNumberDollar AmountDisplay projected tax levies, local revenues (not grants), anticipated (gradually reduced) Transitional Aid, total salary and wages, and total other expenses projected for the three post-application years:
Tax LevyLocal RevenuesTransitional AidTotal S&WTotal OEFirst yearSecond yearThird year
VIII. Financial Practices
A. Expenditure controls and practices:
QuestionYesNo1. Is an encumbrance system used for the current fund?2. Is an encumbrance system used for other funds?3. Is a general ledger maintained for the current fund?4. Is a general ledger maintained for other funds?5. Are financial activities largely automated?6. Does the municipality operate the general public assistance program?7. Are expenditures controlled centrally (Yes) or de-centrally by dept. (No)?8. At any point during the year are expenditures routinely frozen?9. Has the municipality adopted a cash management plan?10. Have all negative findings in the prior years audit report been corrected? If No, list those uncorrected as an appendix.
B. Risk Management: Indicate (x) how each type of risk is insured.
CoverageJIF/HIFSelfCommercialGeneral liabilityVehicle/Fleet liabilityWorkers CompensationProperty Coverage Public Official LiabilityEmployment Practices LiabilityEnvironmentalHealth SHBP
C. Salary and Employee Contract Information (when more than one bargaining unit for each category, use average):
QuestionPoliceFireOther ContractNon-ContractYear of last salary increaseAverage percentage increase%%%%Last contract settlement dateContract expiration date
Explain if any of the following actions have been taken or are under consideration for the Application Year:
ActionPoliceFireOther ContractNon-ContractFurloughs (describe below)
Wage Freezes (describe below)
Layoffs (describe below)
D. Tax enforcement practices:
QuestionYesNo1. Does the municipality use the accelerated tax sale program? 2. When was the last foreclosure action taken or tax assignment sale held: Date:3. During 2009, on what dates were tax delinquency notices sent out: Date:4. Date of last tax sale: Date:Specialized Service Delivery:
If the answer to either question is Yes, provide (as an appendix) a cost justification of maintaining the service without changes.
ServiceYesNoSworn police or firefighters are used to handle emergency service call-taking and dispatch (in lieu of civilians)The municipality provides rear-yard solid waste collection through the budgetF. Other Financial Practices
1. Amount of interest on investment earned in:
Prior Year:$Last Year: $Anticipated Application Year: $
2. List the instruments in which idle funds are invested:
3. What was the average return on investments during CY 2009?%4. When was the last time fee schedules were reviewed and updated?Status of Collective Negotiation (Labor) Agreements: List each labor agreement by employee group, contract expiration date, and the status of negotiations of expired contracts.
Employee GroupExpiration DateStatus of Negotiations of Expired Agreement IX-A. Demonstrated reductions or actions that limited otherwise ordinary increases in Salary and Wage costs.
(See item B-4 in Local Finance Notice 2010-14 for details)
S&W Line ItemPrior Year ActualApplication Year ProposedExplanation of Change IX-B. Demonstrated reductions or actions that limited otherwise ordinary increases in Other Expense or other costs.
(See item B-6 in Local Finance Notice 2010-14 for details). Include changes in spending policies that reduce non-essential spending.
Line ItemPrior Year ActualApplication Year ProposedExplanation of ChangeIX-C. Evaluate existing local revenues, as to whether or not the rates or collections can be increased, and if so, how changes will be implemented. (See B-7 in Local Finance Notice 2010-14 for details)
Local RevenuesPrior Year RealizedApplication Year AnticipatedEvaluation, Recommendation, and Implementation Plan X. Service Delivery
List all services that the municipality contracts to another organization: i.e., shared services with another government agency, including formal and informal shared services, memberships in cooperative purchasing program, private (commercial), or non-profit organization.
ServiceName of Contracted EntityEstimated Amount of ContractYear Last Negotiated
(as applicable)
Section XI Impact of Limited or No Aid Award
Describe in complete detail the impact if aid is not granted for the current fiscal year; this priority setting requires that the municipality will maintain a minimum level of essential services. List the appropriate category of impact if the aid is not received. Rank each item from both lists as to the order in which elimination will take place. If across the board cuts will be made, indicate under service. For rank order purposes, consider the two sections as one list. The cuts outlined here are one that the municipality is committing to make if they do not receive aid.
Rank OrderDepartment# of LayoffsEffective Date2010 Full Time Staffing2011 Full Time Staffing$ Amount to be SavedIf services will be reduced, describe the service, impact and cost savings associated with it.
Rank OrderServiceCost SavingsImpact on Services XII. Agreement to Improve Financial Position of Municipality
If aid is granted, are you willing to enter into a memorandum of understanding that will, among other restrictions and requirements:
YesNoAllow the Director of Local Government Services to assign management, financial, and operational specialists to assess your municipal operations Implement actions as recommended by the Director to address the findings of Division staff Enter into a Memorandum of Understanding
The undersigned herewith acknowledges the foregoing requirements with which the municipality must comply in order to receive aid as outlined above.
In addition, included with this application is a copy (printed or electronic) of the budget documentation that supports the budget calculation that was provided to the governing body.
Mayor______________________________________________________ Date_________
Chief Financial Officer_________________________________________ Date_________
ATTEST: ___________________________________________________ Date_________
Municipal Clerk
Application Year CY 2010/SFY 2011Municipality:County:
Page PAGE 2
Page PAGE 1
Application Year CY 2010/SFY 2011Municipality:County:
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+ a+ ytc $$If + !v h5 5_#v #v_:V + 0 5 5_/ 4 4
+ a+ ytF $$If + !v h5 5_#v #v_:V + 0 , 5 5_/ 4 4
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+ a+ ytc $$If + !v h5 l5*5*5#v l#v*#v:V + 0 5 l5*5/ 4 4
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+ a+ ytc $$If + !v h5 l5*5*5#v l#v*#v:V + 0 5 l5*5/ 4 4
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