various Content of Item 28 -- Location of Operation

Attachment D-12
2007 Economic Census

Information Sector

Content for Item 28a and 28b – Locations of Operation

IN-51250, IN-51251, IN-51750, IN-51751
NC-99650

U.S. DEPARTMENT OF COMMERCE

FORM
(DRAFT)

Economics and Statistics Administration

U.S. CENSUS BUREAU

List of Establishments

Refer to this
CENSUS FILE NUMBER
in any correspondence
pertaining to this report.

28 A. PRE-IDENTIFIED LOCATIONS OF OPERATIONS
We have listed establishments of your company based
on Census records. Please update this list as follows:
• Column (a) - Correct any errors or omissions in the
information. The establishments are listed in the
following sequence: Employer Identification Number
(EIN) and geographic location.

• Column (b) - Report separately the number of
employees and payroll for both paid and leased
employees for each establishment, including part-year
operations. Do not combine data for establishments.
If book figures are not available for employment and
payroll for each establishment, please provide your
best estimates.
• Column (c) - Report status of each establishment at

the end of 2007.

Company Establishments and Subsidiaries (Add store or
plant number, if any and correct any errors or omissions.)

2007 Employment and
Payroll (Report the number of
employees and payroll for each
establishment, including partyear operations.)

Operational Status at the End of 2007 (Mark "X"
only ONE box.)

(a)

(b)

(c)

NAICS

Major activity

Name

Physical location (Number and street)

State

ZIP Code

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

$ Mil.

NAICS

Major activity

Name

Physical location (Number and street)

State

ZIP Code

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

USCENSUSBUREAU

Day

Year

2007
Leased employees
Mailing address (No. and street, P.O. box, etc.)

$ Mil.

Thou.

City, town, village, etc. State

ZIP Code

Other Specify
2007
Paid employees

$ Mil.

Thou.

In
operation
Ceased
operation Give date at
right

Temporarily or
seasonally inactive
Month

Day

Year

Sold or leased to another operator - Give
date above AND enter name and mailing
address below
Name of new owner or operator
2007
Leased employees
Mailing address (No. and street, P.O. box, etc.)

$ Mil.

Thou.

Annual
payroll
PENALTY FOR FAILURE TO REPORT

Month

Sold or leased to another operator - Give
date above AND enter name and mailing
address below
Name of new owner or operator

Annual
Store or plant No. payroll

Secondary name

City, town, village, etc.

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Temporarily or
seasonally inactive

Thou.

Annual
payroll
Line No. EIN

In
operation
Ceased
operation Give date at
right

Annual
Store or plant No. payroll

Secondary name

City, town, village, etc.

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

2007
Paid employees

Produced by GIDS AutoFormatter v4.46,
on 26-Jun-2006 at 11:09 AM

City, town, village, etc. State

Other Specify

ZIP Code

99650012

Line No. EIN

IN-51250, IN-51251, IN-51750, IN-51751

Form NC-99650

(DRAFT)

28 A. PRE-IDENTIFIED LOCATIONS OF OPERATIONS - Continued

Major activity

Name

Annual
Store or plant No. payroll

Secondary name

Physical location (Number and street)

City, town, village, etc.

(b) 2007 Employment and Payroll
2007
Number of
Paid
employees
employees
for pay
period
including
March 12
First
$ Mil.
Thou.
quarter
payroll
(Jan.-Mar.)

State

ZIP Code

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

NAICS

Major activity

Name

Physical location (Number and street)

State

ZIP Code

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

$ Mil.

Thou.

NAICS

Major activity

Name

2007
Paid employees

Physical location (Number and street)

State

ZIP Code

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Day

Year

Sold or leased to another operator - Give
date above AND enter name and mailing
address below
Name of new owner or operator

City, town, village, etc. State

In
operation
Ceased
operation Give date at
right

$ Mil.

ZIP Code

Temporarily or
seasonally inactive
Month

Day

Year

Thou.
Sold or leased to another operator - Give
date above AND enter name and mailing
address below
Name of new owner or operator

2007
Leased employees
Mailing address (No. and street, P.O. box, etc.)

$ Mil.

Thou.

City, town, village, etc. State

ZIP Code

Other Specify
2007
Paid employees

$ Mil.

Thou.

In
operation
Ceased
operation Give date at
right

Temporarily or
seasonally inactive
Month

Day

Year

Sold or leased to another operator - Give
date above AND enter name and mailing
address below
Name of new owner or operator

Annual
Store or plant No. payroll

Secondary name

City, town, village, etc.

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Month

Other Specify

Annual
payroll
Line No. EIN

Ceased
operation Give date at
right

Temporarily or
seasonally inactive

Mailing address (No. and street, P.O. box, etc.)

Annual
Store or plant No. payroll

Secondary name

City, town, village, etc.

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

In
operation

2007
Leased employees

Annual
payroll
Line No. EIN

(c) Operational Status at the End of 2007

2007
Leased employees
Mailing address (No. and street, P.O. box, etc.)

$ Mil.

Thou.

Annual
payroll
Produced by GIDS AutoFormatter v4.46,
on 26-Jun-2006 at 11:09 AM

City, town, village, etc. State

Other Specify

ZIP Code

99650020

(a) Company Establishments and Subsidiaries
Line No. EIN
NAICS

IN-51250, IN-51251, IN-51750, IN-51751
NC-99651

U.S. DEPARTMENT OF COMMERCE

FORM
(DRAFT)

Economics and Statistics Administration

U.S. CENSUS BUREAU

List of Establishments

Refer to this
CENSUS FILE NUMBER
in any correspondence
pertaining to this report.

28 B. ADDITIONAL LOCATIONS OF OPERATIONS
Column (a) - List separately any establishments
of your company and its subsidiaries that
were not included on the PRE-IDENTIFIED
LOCATIONS OF OPERATIONS but were in
operation and engaged in the industry printed
in the mailing address section on the first
page of the consolidated report form. If your
company operates at locations for which you
have received separate report forms, do not list
them, instead complete those forms. For acquired
establishments that you list, complete column
(c2).
Column (b) - Report number of employees and
payroll for both paid and leased employees
for each establishment, including part-year
operations.
Column (c1) - Enter the code from the MAJOR
ACTIVITY CODES list that best describes the
activity of each establishment and specify the
principal products or services.
Column (c2) - Complete for acquired
establishments.

MAJOR ACTIVITY CODES FOR COLUMN (c1)
Motion picture and sound
01 - Motion picture and video production, including
establishments of production companies distributing films
(whether for own company or for other companies)
02 - Motion picture and video distribution for other
companies only
03 - Integrated record production/distribution
Telecommunications and cable
04 - Wired telecommunications carrier
05 - Paging services
06 - Cellular and other wireless telecommunications
07 - Cable and other program distribution
Other
08 - Administrative office or other enterprise support
establishment providing services (e.g., management, billing,
etc.) to your own company
09 - Other - Specify major activity along with principal
products or services in column (c1) below.

IMPORTANT - DO NOT DUPLICATE ESTABLISHMENTS PRELISTED IN 28 A.
2007 Employment and
Company Establishments and Subsidiaries (Employer
Payroll (Report the number of
Identification Number (EIN), establishment name, your
store or plant number, if any, address of physical location, employees and payroll for each
establishment, including partincluding ZIP Code)
year operations.)
(b)

Line No. EIN

Number of
employees
for pay
period
including
March 12
First
quarter
Store or plant No. payroll
(Jan.-Mar.)

Name

Secondary name

Date establishment
opened or is expected to
open . . . . . . . . . . .

State

Month

Paid employees
Code

$ Mil.

ZIP Code

Day

Year

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Former Owner or Operator
(c2)
Name of former owner or operator
2007
Leased employees

USCENSUSBUREAU

Mailing address (No. and street, P.O. box, etc.)

City, town, village, etc. State
$ Mil.

ZIP Code

Thou.

Annual
payroll
PENALTY FOR FAILURE TO REPORT

Specify

Thou.

Annual
payroll

Physical location (Number and street)

City, town, village, etc.

(c1)
2007

99651010

(a)

Major Activity in 2007 (Enter the code from the
MAJOR ACTIVITY CODES list and specify the
principal products or services.)

Produced by GIDS AutoFormatter v4.46,
on 26-Jun-2006 at 11:11 AM

Month
Date acquired . . . . .

Year

IN-51250, IN-51251, IN-51750, IN-51751

Form NC-99651

(DRAFT)

28 B. ADDITIONAL LOCATIONS OF OPERATIONS - Continued
(a) Company Establishments and Subsidiaries
Line No. EIN

(b) 2007 Employment and Payroll
2007
Number of
Paid employees
employees
for pay
period
including
March 12
First
$ Mil.
Thou.
quarter
Store or plant No. payroll
(Jan.-Mar.)

Name

Secondary name

City, town, village, etc.

Date establishment
opened or is expected to
open . . . . . . . . . . .

State

Month

ZIP Code

Day

Year

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

2007
Leased employees

Number of
employees
for pay
period
including
March 12
First
quarter
Store or plant No. payroll
(Jan.-Mar.)

Name

Secondary name

City, town, village, etc.

Date establishment
opened or is expected to
open . . . . . . . . . . .

State

Month

ZIP Code

Day

Year

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Number of
employees
for pay
period
including
March 12
First
quarter
Store or plant No. payroll
(Jan.-Mar.)

Name

Secondary name

City, town, village, etc.

Date establishment
opened or is expected to
open . . . . . . . . . . .

State

Month

ZIP Code

Day

Year

Number of
employees
for pay
period
including
March 12
First
quarter
payroll
(Jan.-Mar.)

Year

Date acquired . . . . .
2007
Paid employees
Code

$ Mil.

Specify

Thou.
Former Owner or Operator
(c2)
Name of former owner or operator

2007
Leased employees

Mailing address (No. and street, P.O. box, etc.)

City, town, village, etc. State
$ Mil.

ZIP Code

Thou.
Month

Year

Date acquired . . . . .
2007
Paid employees
Code

$ Mil.

Specify

Thou.
Former Owner or Operator
(c2)
Name of former owner or operator

Annual
payroll

Physical location (Number and street)

ZIP Code

Month

Annual
payroll
Line No. EIN

Mailing address (No. and street, P.O. box, etc.)

Thou.

Annual
payroll

Physical location (Number and street)

Former Owner or Operator
(c2)

City, town, village, etc. State
$ Mil.

Annual
payroll
Line No. EIN

Specify

Name of former owner or operator

Annual
payroll

Physical location (Number and street)

Code

2007
Leased employees

Mailing address (No. and street, P.O. box, etc.)

City, town, village, etc. State
$ Mil.

99651028

-

(c1) Major Activity in 2007

ZIP Code

Thou.

Annual
payroll
Produced by GIDS AutoFormatter v4.46,
on 26-Jun-2006 at 11:11 AM

Month
Date acquired . . . . .

Year