This form is designed to capture information around subsequent events, transactions and changes at each agency AFTER submission of the year end questionnaire on 9/30. Please keep in mind as you read the questions that your answers are regarding YOUR agency and for the period of 10/1 through 11/30.

The questions included in this questionnaire are designed to help you think about the types of things that might happen subsequent to fiscal year end that would need reported to the SAO Accounting Division. The questionnaire is not designed to be all inclusive of any event that needs reported. There may be events that occur outside of these examples that you should report. Also, remember as you answer that the types of events, transactions and changes that you need to report to us are ones that are or could be significant to either 1) conditions that existed at 6/30, or 2) new events that did not exist as of 6/30 that could affect a financial statement user's understanding of the financial statements. Please watch the video on our website called Year End-Subsequent Events Questionnaires and Rep Letter for further explanation/information.

If you have any questions regarding any portion of this questionnaire, please let SAO Accounting Division know and either we or the external auditors will attempt to address your concerns.

Should you have no further questions, please complete the questionnaire. When you click submit, your answers are returned electronically to the SAO Accounting Division.

This questionnaire needs to be completed and returned to the SAO Accounting Division by November 30.

Please answer the following questions (Yes or No) for events occurring after submission of the Year End Questionnaire on September 30.

If answer is Yes, please provide detail description in space provided.

If no explanation is provided for any 'yes' selections, we will be contacting you for more information.

• Any litigation, asserted or unasserted claims?*
  • Yes
  • No
• Any concerns or allegations related to fraud that have been reported?*
  • Yes
  • No
• Any substantial contingent liabilities or commitments?*
  • Yes
  • No
• Whether any regulatory agencies have issued any reports or letters?*
  • Yes
  • No
• Any significant audits performed that would result in large amounts due to/from the State?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Were there any changes in value of recorded assets that existed at the balance sheet date? Consider the following.

• Assets that have been sold, abandoned, destroyed, damaged or otherwise impaired?*
  • Yes
  • No
• Losses as a result of fire, flood or other disasters?*
  • Yes
  • No
• Changes in the coverage of all insurable risks that could result in a catastrophe?*
  • Yes
  • No
• A combination or purchase?*
  • Yes
  • No
• Indication of any loss or market value decline on assets?*
  • Yes
  • No
• Adverse changes in value of equity investments?*
  • Yes
  • No
• If yes to any of the above, please explain:
• Assets in dispute or being contested?*
  • Yes
  • No

• Did any of the following occur?

• Changes in any substantial liabilities, contingencies or commitments that existed at the date of the balance sheet or at the date of this inquiry?*
  • Yes
  • No
• Changes in long term debt or working capital to the date of this inquiry (including details of significant covenants)?*
  • Yes
  • No
• Pollution remediation obligating event(s)?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Any liabilities in dispute or being contested including creditors' claims on invoices, product warranties or guarantees, etc. including:

• Changes in liabilities that were accounted for on the basis of preliminary data?*
  • Yes
  • No
• Change in tax assessment?*
  • Yes
  • No
• Lawsuits that have been filed or settled?*
  • Yes
  • No
• Commitments or plans for capital expenditures?*
  • Yes
  • No
• Evidence of noncompliance including regulatory inquiry or investigation?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Did any changes in capital structure occur?

• Were there any changes in management/ownership?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Did any changes in capital structure occur?

• Loss of major customers or taxpayers?*
  • Yes
  • No
• Adverse revenue trends and/or market conditions?*
  • Yes
  • No
• Any significant change or cancellation of grant awards?*
  • Yes
  • No
• Existing sales or contractual commitments that might result in possible loss to the entity or should be disclosed?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Changes in costs/expenses. Did any of the following occur:

• Increase in the cost of the entity's basic raw materials?*
  • Yes
  • No
• A decrease in the cost of basic raw materials evidencing possible inventory losses?*
  • Yes
  • No
• Adverse impacts of wage negotiations or any new pension or compensation plans?*
  • Yes
  • No
• Energy or other material shortages of significance to the entity's operations?*
  • Yes
  • No
• Existing purchase commitments that might result in possible loss to the entity?*
  • Yes
  • No
• Significant transactions or events pertaining to investees that would require disclosure?*
  • Yes
  • No
• Laws or regulations or determinations by other governmental bodies that might adversely affect the entity?*
  • Yes
  • No
• If yes to any of the above, please explain:

• Did any of the following occur?

• Financing agreements which require assets to be pledged or otherwise restricted?*
  • Yes
  • No
• Liabilities which have been settled for less than face value?*
  • Yes
  • No
• Material amounts of accounts receivables that have become delinquent, doubtful or uncollectible?*
  • Yes
  • No
• Events which render a material amount of capital assets inoperable or obsolete (see also impairment of capital assets)?*
  • Yes
  • No
• Issuance of debt?*
  • Yes
  • No
• Outstanding obligations which cannot be met?*
  • Yes
  • No
• Audits which are other than routine?*
  • Yes
  • No
• New lease agreements?*
  • Yes
  • No
• Lawsuits filed by or against an organization?*
  • Yes
  • No
• Early retirement of debt?*
  • Yes
  • No
• Large or unusual commitments for materials or services?*
  • Yes
  • No
• If yes to any of the above, please explain:
• Are you aware of any event occurring after submission of the Year End Questionnaire on 9/30 that qualifies as a subsequent event?*
  • Yes
  • No
• If yes to the above, please explain: