(Set forth in the following form, the figures showing whether the

self-liquidating utility(s) have supported themselves during fiscal year 2009

Utility

Utility

  1. Total Cash Receipts from Fees,
  2. Rents or other Charges for Year (509 1-00)
  3. Operating and Maintenance Cost (509 2-00)
  4. Debt Service per Sewer Accounts
  5. Interest (509 3-00)
  6. Notes (509 4-00)
  7. Serial Bonds (509 5-00)
  8. Sinking Fund Requirement (509 6-00)
  9. Debt Service per Current Budget
  10. (N.J.S.A. 40A:2-52)
  11. Interest on
  12. Refunding Bonds (509 7-00)
  13. Refunding Bonds (509 8-00)
  14. Anticipated Deficit in Dedicated
  15. Assessment Budget (509 9-00)
  16. Total Debt Service (510 0-00) $0.00
  17. Total Deductions(Line 2 plus Line 6) (510 1-00) $0.00
  18. Excess in Revenues(Line 1 minus Line 7) (510 2-00) $0.00
  19. Deficit in Revenues(Line 7 minus Line 1) (510 3-00)
  20. Total Debt Service(Line 6) (510 4-00) $0.00
  21. Deficit(smaller of Line 9 or Line 10) to Page 5 (510 5-00)
  22. If Excess in Revenues (Line 8) all Utility Debt is Deductible
  23. Utility
  24. (Insert Applicable Utility)
  25. Total Cash Receipts from Fees,
  26. Rents or other Charges for Year (509 1-00) 0
  27. Operating and Maintenance Cost (509 2-00) 0.00
  28. Debt Service per Water Accounts
  29. Interest (509 3-00) 0.00
  30. Notes (509 4-00)
  31. Serial Bonds (509 5-00) 0.00
  32. Sinking Fund Requirement (509 6-00)
  33. Debt Service per Current Budget
  34. (N.J.S.A. 40A:2-52)
  35. Interest on
  36. Refunding Bonds (509 7-00)
  37. Refunding Bonds (509 8-00)
  38. Anticipated Deficit in Dedicated
  39. Assessment Budget (509 9-00)
  40. Total Debt Service (510 0-00)
  41. Total Deductions(Line 13 plus Line 17) (510 1-00)
  42. Excess in Revenues(Line 12 minus Line 18) (510 2-00)
  43. Deficit in Revenues (Line 18 minus Line 12) (510 3-00)
  44. Total Debt Service (Line 17) (510 4-00)
  45. Deficit(smaller of Line 20 or Line 21) to Page 5 (510 5-00)

If Excess in Revenues (Line 19) all Utility Debt is Deductible

If Excess in Revenues (Line 19)all ___ Utility Debt is Deductible (If Municipality has other utilities or enterprises, additional pages are to be added to this statement.)