Sheet 1: Worksheet

	
	
	
	
	
	

		


		


		
Actual - Previous 3 Years
		


		
Estimated - Next 5 Years, Starting with Current Fiscal Year
		
	

		


		


		
2015
		
2016
		
2017
		


		
2018
		
2019
		
2020
		
2021
		
2022
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Last year rate increase/Proposed Rate Increase
		


		
0.0%
		
0.0%
		
0.0%
		


		
0.0%
		
0.0%
		
0.0%
		
0.0%
		
0.0%
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Operating Revenues
		


		


		


		


		


		


		


		


		


		


	
	

		


		
User charge (system) revenue
		
 $- 
		
 $- 
		
 $- 
		


		
 $- 
		
 $- 
		
 $- 
		
 $- 
		
 $- 
	
	

		


		
Contributions from customers - tap fees
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Late fees
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (please describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (please describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Total Operating Revenues
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Operating Expenses
		


		


		


		


		


		


		


		


		


		


	
	

		


		
Salaries & Wages
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Benefits
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Professional fees
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Engineering fees
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Repairs and maintenance
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Utilities
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Supplies
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Miscellaneous
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (Describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (Describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Total Operating Expenses
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Operating Income Before Depreciation
		


		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Depreciation
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		
TOTAL OPERATING INCOME
		


		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Non Operating Revenues (Expenses)
		


		


		


		


		


		


		


		


		


		


	
	

		


		
Investment Income
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Grant
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Property Taxes
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Debt Service (Princial and Interest) - Existing prior to this loan
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (Describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Total Non-Operating Income (Loss)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Net Change in Position Before Capital Items
		


		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Capital Items
		


		


		


		


		


		


		


		


		


		


	
	

		


		
Transfers (Describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
New IEPA Debt Service
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Other (Describe)
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		
Total Capital Items
		
 - 
		
 - 
		
 - 
		


		
 - 
		
 - 
		
 - 
		
 - 
		
 - 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
NET CHANGE IN POSITION
		


		
 $- 
		
 $- 
		
 $- 
		


		
 $- 
		
 $- 
		
 $- 
		
 $- 
		
 $- 
	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		
Includes minimum required information. Applicant may modify and expand this form to reflect the actual detailed revenue, expense, and reserves of the system. The applicant may also submit their own forms. Contact the Infrastructure Finance Assistance Center if you need additional assistance.