BE-13C Exemption Claim, Form BE-13

OMB Control No. 0608-0035: Approval Expires 09/30/2006
FORM BE-13
(REV. 12/2003)

U.S. DEPARTMENT OF COMMERCE

Supplement C

BUREAU OF ECONOMIC ANALYSIS

CONTROL NUMBER
The combined public reporting burden for related Forems BE-13, BE-13 Supplement C,
and BE-14 is estimated to vary from 1 to 4 hours per response, with an average of 1.5
hours per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to
Director, Bureau of Economic analysis (BE-1), U.S. Department and Commerce,
Washington, DC 20230; and to the Office of Management and Budget, Paperwork
Reduction Project 0608-0035, Washington, DC 20503.

EXEMPTION CLAIM, FORM BE-13
(Initial Report on a Foreign Person’s Direct or Indirect Acquisition,
Establishment, or Purchase of the Operating Assets, of a U.S.
Business Enterprise, Including Real Estate)

ELECTRONIC FILING

See our web site at www.bea.gov/astar for details.

U.S. Department of Commerce
Bureau of Economic Analysis
BE-49(NI)
Washington, DC 20230

MAIL
REPORTS
TO

U.S. Department of Commerce
Bureau of Economic Analysis, BE-49(NI)
Shipping and Receiving Section M-100
1441 L Street, NW
Washington, DC 20005

DELIVER
REPORTS
TO

Mandatory – This survey is being conducted pursuant to the
International Investment and Trade in Services Survey Act (P.L.
94-472, 90 Stat. 2059, 22 U.S.C., 3101-3108, as amended –
hereinafter "the Act"), and the filing of reports is MANDATORY
pursuant to Section 5(b)(2) of the Act (22 U.S.C. 3104). The
implementing regulations are contained in Title 15 CFR Part 806.
This report has been approved by the Office of Management and
Budget under the Paperwork Reduction Act (44 U.S.C. 3501, et seq.).

conviction, may be punished by a like fine, imprisonment, or both.
(22 U.S.C. 3105)
Notwithstanding any other provision of the law, no person is
required to respond to, nor shall any person be subject to a penalty
for failure to comply with, a collection of information subject to the
requirements of the Paperwork Reduction Act, unless that
collection of information displays a currently valid OMB Control
Number.

Penalties – Whoever fails to report may be subject to a civil
penalty of not less than $2,500, and not more than $25,000, and to
injunctive relief commanding such person to comply, or both.
Whoever willfully fails to report shall be fined not more than
$10,000 and, if an individual, may be imprisoned for not more than
one year, or both. Any officer, director, employee, or agent of any
corporation who knowingly participates in such violation, upon

Confidentiality – The Act provides that your report to this Bureau
is CONFIDENTIAL, and may be used only for analytical or statistical
purposes. Without your prior written permission, the information
filed in your report CANNOT be presented in a manner that allows it
to be individually identified. Your report CANNOT be used for
purposes of taxation, investigation, or regulation. Copies retained in
your files are immune from legal process.

This U.S. business enterprise is exempt from filing a Form BE-13 because:
Mark (X) one of items 1 through 5
1.

160

This U.S. business enterprise is not a U.S. affiliate of a foreign person, i.e., is not owned to the
extent of 10 percent or more, directly or indirectly, by a foreign person.

2.

110

This acquisition is exempt from being reported because the U.S. business enterprise, or the
business segment or operating unit of a U.S. business enterprise, was acquired by an
existing U.S. affiliate who then merged it into its own operations and the total cost of the
acquisition was $3 million or less, and did not involve the purchase of 200 acres or more of U.S.
land. (If the purchase involves 200 acres or more of U.S. land, it must be reported regardless of
the total cost of the acquisition.) Enter the total cost and number of acres.

Amount of total cost
Bil.
Mil. Thous. Dols.
173 $

Number of acres
(to nearest whole acre)
135

3.

150

This acquisition is not required to be reported since it represents U.S. real estate acquired by
a foreign person(s) held exclusively for personal use and not for profitmaking purposes.

4.

205

This U.S. business enterprise is a U.S. affiliate of a foreign person but is exempt because, on a fully consolidated domestic U.S. basis
(a) Total assets (not the foreign parent’s or existing U.S. affiliate’s share) at the time of
acquisition or immediately after being established were $3 million or less;
and
(b) The U.S. affiliate does not own 200 acres or more of U.S.
land (if the U.S. affiliate owns 200 acres or more of U.S. land,
it must report regardless of the value of the total assets).
Enter value
or amount
for each

Bil.
131 $

i. Total assets (do not net out liabilities)
ii. Sales or gross operating revenues, excluding
sales taxes (do not give gross margin)
iii. Net income after provision for U.S. income
taxes

Amount
Mil. Thous. Dols.

201 $
133 $

Number

iv. Number of acres of U.S. land owned
(to nearest whole acre)

135

ISI Code

v. Industry of this affiliate – Enter the 4-digit ISI code
of the industry with the largest sales or gross
operating revenues. See the list of ISI codes,
103
pages 5 and 6 of Form BE-13.
and complete
the following

BEA USE ONLY

vi. Country of foreign parent

108

vii. Country of ultimate
beneficial owner

124

CERTIFICATION — The undersigned official certifies that this report has been
prepared in accordance with the applicable instructions, is complete, and is substantially
accurate except that, in accordance with III.G. of the Instructions, estimates have
been provided where data are not available from customary accounting records or
precise data could not be obtained without undue burden.

PERSON TO CONSULT CONCERNING QUESTIONS ABOUT THIS
REPORT — Enter name and address
Name

1000

1

Address
Report currency amounts in U.S. dollars rounded to thousands
TELEPHONE
NUMBER
FAX NUMBER

1001

1

Area code

2

Number

4

Area code

5

Number

May we use e-mail to correspond with you to discuss questions relating
to this Form BE-13 Supplement C, including questions that may contain
information about this transaction that you may consider confidential?
(Note that electronic mail is not inherently confidential; we will treat
information we receive as confidential, but your e-mail is not necessarily
secure against interception by a third party.)

Date

Authorized official’s signature

(omitting
000).— If amount is $1,334,615.00, report as
EXAMPLE
3

Extension

Print or type name and title
Telephone number

1027

1

1

FAX number
E-mail address

1

Yes — If yes, please
provide your
e-mail address.

2

No

1

1028

CONTINUE ON REVERSE SIDE

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5.

14

Other – Specify and include reference to section of regulations or instructions on which claim is based.

Month

Day

Year

102

6. If item 2 or item 4 was marked, enter date transaction was completed

7. Name and address (enter in blocks below, as appropriate; leave one block between words)
(i) If item 1, 3, or 5 was marked, enter name and address in a. below of the U.S. business enterprise (including real
estate) claiming an exemption.
(ii) If item 2 or 4 was marked, enter the name and address of the new U.S. affiliate acquired or established in a. below.
If the transaction involved an acquisition by an existing U.S. affiliate, also give name and address of the existing
U.S. affiliate in b. below that made the acquisition, and the percentage of ownership it acquired.
a. Name and address of new U.S. affiliate acquired or established, or the entity claiming an exemption.
Name
104

Street or PO Box
105

City and State

ZIP Code

106

b. Name and address of existing U.S. affiliate and percent acquired of affiliate named in a. above (if (ii) applies).
Name
147

Street or PO Box
148

City and State

ZIP Code

149

% of a. acquired
109

.

%

Remarks

FORM BE-13 Supplement C (12/2003)

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