BONDS AND NOTES FOR SELF LIQUIDATING PURPOSES A. Water SYSTEM (insert Applicable Utility)

1. (503 1-00) $___
1. Terms Bonds
2. Serial bonds
3. (a)Issued (503 2-00) $ \underline{\hspace{20}} 548,175.69
4. (b)Authorized but not issued (503 3-00) $ \underline{\hspace{2cm}} 0.00
3. Refunding Bonds (N.J.S.A. 40A:2-52)
3. Refunding Bonds (NJ.S.A. 40A:2-52)
4. (a)Issued
5. (b)Authorized but not issued (503 5-00) $_____
4. Bond Anticipation Notes
5. (a)Issued
6. (503 6-00) $ ___ 0.00
7. (b)Authorized but not issued (503 7-00) $ \underline{\hspace{2cm}} 0.00
5. Capital Notes (N.J.S.A. 40A:2-8)
5. Capital Notes (NJ.SA 40A:2-8)
6. (a)Issued
7. (b)Authorized but not issued (503 9-00) $ ___
6. Other
6. Other
7. (a)Issued
8. (a)Issued
9. (b)Authorized but not issued (503 1100) $ 7 Total $548,175.69 (503 0-00)
10. B. SYSTEM (insert Applicable Utility)
11. (503 1-00) $___
12. 8 Terms Bonds
13. (a)9 Serial bonds (a) Issued (503 2-00) $___
14. (b)Authorized but not issued (503 3-00) $_____
15. (a)10 Refunding Bonds (N.J.S.A. 40A:2-52) (a) Issued (503 4-00) $ ___
16. (b)Authorized but not issued (503 5-00) $ ___
17. (a)11 Bond anticipation notes (a) Issued (503 6-00) $_____
18. (b)Authorized but not issued (503 7-00) $ ___
19. (a)12 Capital Notes (N.J.S.A. 40A:2-8) (a) Issued (503 8-00) $ ___
20. (b)Authorized but not issued (503 9-00) $ ___
21. (a)13 Other (a) Issued
22. (a)Issued (503 10-00) $ ___
23. (b)Authorized but not issued (503 11-00) [4 Total0.00 (503 0-00)

WHICH MUNICIPALITY DERIVES REVENUE (state on a separate sheet in the manner stated above) Total $___

Page Total ___548,175.69 (50409-00)