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 |  |  | Economics and Statistics Administration
 |  |  | U.S. CENSUS BUREAU
 |  |  | FORM |  |  |  |  |  |  |  | 2008 Supplemental Survey of Locally Administered
 |  |  | F-11(S) (2008) |  |  |  |  |  |  |  | Public-Employee Retirement Systems
 |  |  | (10/15/2008)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | OMB No. 0607-0585: Approval Expires 06/30/2010
 |  |  |  |  |  |  |  |  |  | In correspondence pertaining to this report, please refer to the ID printed above your address.
 | RETURN TO:
 | U.S. Census Bureau
 | 1201 East 10th Street
 | Jeffersonville, IN 47132-0001
 | If you have any questions,
 | please call [PHONE]
 | weekdays, 8:00 a.m. to
 | 5:30 p.m. EST.
 | Questions can also be
 | e-mailed to:
 | [EMAIL]
 |  |  |  |  |  |  |  |  |  | Please correct any errors in name, address, or ZIP Code.
[NAME]
You may respond to this survey via the Internet at the following web address:  http://harvester.census.gov/sgfnet
You will only need your User ID to access the Internet form.  Your User ID is the first 14 digits of the 18 digit ID
located on the top line of the address section above.
GENERAL INSTRUCTIONS
Before filling out this form, please read carefully each part and all related definitions and instructions.
Note especially:
1. | Report for Defined Contribution and Postemployment Healthcare plans only.
2. | Report corporate stocks and bonds at market value, and adhere to Governmental Accounting Standards
 | Board (GASB) guidelines when reporting gains and losses on investments.
3. | Report figures relating to all accounts and reserves of your system, including amounts for retirement,
 | disability, survivors, and other benefits, as well as any amounts for administration of the system.
 | Report in whole dollars.  Exclude transfers between reserves of the system, and also any investment
 | transactions relating to loans to system members.
4. | Do not delay reporting to await finally audited figures, if substantially accurate figures can be supplied on a
 | preliminary basis.
5. | Use a black or blue ball point pen.
 | RESPONDENT INFORMATION:
 | Name of person completing report - Please print |  |  |  |  |  |  |  |  |  |  | Title of person completing report - Please print
 | Area Code |  |  | Telephone Number |  |  | Extension |  |  |  |  | E-mail Address - Please print
Part 1 |  |  |  |  |  | PLAN INFORMATION FOR DEFINED CONTRIBUTION PLANS
 | A. |  | Does your system offer a defined contribution plan? |  |  |  |  |  |  |  |  |  |  |  | Yes |  | No
 |  |  | If not, skip to part 5.
 | B. |  | Are new employees covered under this pension plan? |  |  |  |  |  |  |  |  |  |  |  | Yes |  | No
 | C. |  | List all defined contribution plans that your system offers below.
 |  |  | Report summary data combining all defined contribution plans.
Please continue on the next page