SA-8114A Service Annual Survey

OMB No. 0607-0422: Approval Expires 12/31/2006

2005 Annual Services Report
Service Annual Survey

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

Personal and Household Goods Repair and Maintenance

FORM

SA-8114A

140
811430

SAS_G
T

REPORT DUE

Any questions call 1–800–772–7851
M–F, 8:30 a.m. to 5:00 p.m. EST.
Please correct any error in the name, address, or ZIP Code.

YOUR RESPONSE IS REQUIRED BY LAW
Title 13, U.S. Code, requires businesses and other organizations that receive this questionnaire to answer the
questions and return the report to the Census Bureau.

YOUR RESPONSE IS CONFIDENTIAL BY LAW
Title 13, U.S. Code, requires that your response may be seen only by persons sworn to uphold the confidentiality of Census
Bureau information and may be used only for statistical purposes. The law also provides that copies retained in your files are
immune from legal process.

YOUR RESPONSE IS IMPORTANT
The services industries account for nearly 70 percent of all economic activity. We conduct this survey to obtain timely,
comprehensive and consistent measures needed by policy-makers, businesses, and the public to accurately assess domestic
economic performance.

FORM asr_a_05 (1-13-2006)

USCENSUSBUREAU

Page 2

Annual Services Report
•
•

This report should be completed and returned on or before the due date in the preaddressed envelope provided.
If filing within the required time frame will cause an undue burden and you would like an extension, or if you have any questions, please write to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
or call a Census Bureau Representative at 1–800–772–7851, weekdays from 8:30 a.m. to 5:00 p.m., eastern standard time.

1

Report Coverage
This report covers all domestic locations operated by your company and its subsidiaries primarily engaged in
repairing footwear and/or repairing other leather or leather-like goods without retailing new footwear and
leather or leather-like goods, such as handbags and briefcases.

Does the above coverage describe this firm’s business activity?

0001

1
2

Yes – Go to 3
No – Specify the firm’s business activity and complete the report where applicable beginning with 3 .
0002

2 Not Applicable
3 Report Periods
11
What periods of time will this data represent?
• Report data for the 2005 and 2004 calendar years if possible.
• For locations that were sold or acquired during a year, only report for the periods that this firm operated the locations.
2005
Month

Day

2004
Year

Month

0007
1

2005 and 2004 calendar years – Go to 4

2

Other than calendar years – Enter the periods this report will cover. . .
0008
(e.g., fiscal years, periods with less than a full calendar
year).
To

0006

FORM asr_b1_05 (11-23-2005)

From

From

To

Day

Year

Page 3

4 Operating Revenue
Report the total operating revenue for this firm’s locations defined in 1
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company.

for the following categories.

Include revenue for maintenance and delivery services.

2005 Operating Revenue
Bil.
Mil.
Thou.
Dol.

2004 Operating Revenue
Bil.
Mil.
Thou.
Dol.

1800

1. TOTAL OPERATING REVENUE

5 Not Applicable

FORM asr_c_05 (9-23-2005)

..................... $

$

Page 4

6 Operating Expenses
Report operating expenses for this firm’s locations as defined in 1 for the following categories.
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company
• Capitalized expenses
• Interest
• Bad debt
• Impairment
• Income tax

Personnel Costs

2005 Operating Expenses
Mil.
Thou.
Dol.

2004 Operating Expenses
Bil.
Mil.
Thou.
Dol.

Bil.
1. Gross annual payroll – Total annual Medicare salaries and
1821
wages for all employees as reported on your firm’s IRS
Form 941, Employer’s Quarterly Federal Tax Return, line 5(c)
for the four quarters that correspond to the survey period. . . . . . $

$

2. Employer’s cost for fringe benefits – Employer’s cost for
legally required programs and programs not required by law.
Include insurance premiums for hospital plans, medical plans,
and single service plans (e.g., dental, vision, prescription
drugs); premium equivalents for self-insured plans and fees
paid to third-party administrators (TPAs); defined benefit
pension plans; defined contribution plans (e.g., profit sharing,
401K and stock option plans); and other fringe benefits (e.g.,
Social Security, workers’ compensation insurance, un1822
employment tax, state disability insurance programs, life
insurance benefits, Medicare). Do not include employee
contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

3. Temporary staff and leased employee expense – Total
1823
costs paid to Professional Employer Organizations (PEOs)
and staffing agencies for personnel. Include all charges for
payroll, benefits, and services. . . . . . . . . . . . . . . . . . . . . . . . $

$

Expensed Materials, Parts and Supplies (not for resale)
4. Expensed equipment – Expensed computer hardware
and other equipment (e.g., copiers, fax machines, telephones,
1824
shop and lab equipment, CPUs and monitors). Report
packaged software in line 6. Report leased and rented
equipment in line 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

5. Expensed purchases of other materials, parts, and
supplies – Materials and supplies used in providing services
1825
to others; materials and parts used in repairs; office and
janitorial supplies; small tools; containers and other packaging
materials; and motor fuels. . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

Expensed Purchased Services
6. Expensed purchases of software – Purchases of prepackaged,
custom coded, or vendor customized software. Include
software developed or customized by others, web-design
services and purchases, licensing agreements, upgrades of 1826
software; and maintenance fees related to software upgrades
and alterations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

7. Purchased electricity and fuels (except motor fuels) – If
1827
the cost of electricity and heating fuels (e.g., natural gas,
propane, oil, coal) are included in lease or rental payments,
report in line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

8. Lease and rental payments – For land, buildings, offices,
structures, machinery, equipment, and other tangible items.
Include lease and rental of transportation equipment without
operators; and penalties incurred for broken leases. Exclude 1828
capital and financing lease agreements and licensing/leasing
of software. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

FORM asr_g1_05 (1-19-2006)

Page 5

6 Operating Expenses – (Continued)
Report operating expenses for this firm’s locations as defined in 1 for the following categories.
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company
• Capitalized expenses
• Interest
• Bad debt
• Impairment
• Income tax

Expensed Purchased Services – (Continued)
9. Purchased repair and maintenance – Include expensed repair
and maintenance to buildings and integral building components
2005 Operating Expenses
(e.g., elevators, heating and cooling systems), structures, offices,
Bil.
Mil.
Thou.
Dol.
machinery, vehicles, equipment, and computer hardware.
1829
Exclude materials, parts, and supplies used for repair and
maintenance performed by this firm’s employees. Report
janitorial and grounds maintenance services in line 13. . . . . . . . . $

2004 Operating Expenses
Bil.
Mil.
Thou.
Dol.

$

1830

10. Purchased advertising and promotional services – Include
marketing and public relations services. . . . . . . . . . . . . . . . . . . $

$

Other Operating Expenses
11. Depreciation and amortization charges – Include depreciation
charges taken against tangible assets owned and used by your
firm, tangible assets and improvements owned by your firm within
1831
leaseholds, tangible assets obtained through capital lease
agreements, and amortization charges against intangible
assets (e.g., patents, copyrights). Exclude impairment. . . . . . . . . $

$

12. Governmental taxes and license fees – Payments to
government agencies for taxes and licenses. Include business 1832
and property taxes. Exclude income taxes, and sales and
excise taxes collected from customers. . . . . . . . . . . . . . . . . . . . $

$

13. All other operating expenses – Report all other operating
expenses not reported above, unless specifically excluded in
1899
the general instructions at the top of the page. Exclude
purchases of merchandise for resale and non-operating
expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

1900

14. TOTAL OPERATING EXPENSES – Sum of lines 1–13. . . . . . . . $

7 Not Applicable

FORM asr_g2_05 (10-12-2005)

$

Page 6

8 E-Commerce Revenue
E-commerce includes sales and receipts from any transaction completed over an Internet, extranet, EDI network,
electronic mail or other online system. Transactions are agreements between buyers and sellers to transfer ownership
of, or rights to use, goods or services. Payment for these goods and services may or may not be made online.
Include:
• Revenue from online orders for goods or services placed by a buyer.
• Commissions or fees from trading of securities or the sale of other financial products online (insurance, loans, etc.).
• Commissions or fees from selling or facilitating the sale of third party products through your company’s website.
• Commissions or fees from use of computerized reservation systems, financial transaction processing systems, etc.
• Revenue from orders or contracts negotiated online with a buyer and seller on the price and terms for
transferring ownership or the rights to use goods or services.
• Revenue from telephone transactions using interactive voice response systems.
Exclude:
• Online billings where the order or contract was not negotiated online.
• Delivery of services online where the order or contract was not negotiated online.
• Provision of telecommunications systems and related infrastructure systems where the order or contract for such services was
not negotiated online.
• Orders for goods or services placed by fax or over switched telephone network.
• Online advertising.
2005 E-Commerce Revenue
Bil.
Mil.
Thou.
Dol.

Did the revenue reported in 4 include any
e-commerce revenue?
1
0011
2

2004 E-Commerce Revenue
Bil.
Mil.
Thou.
Dol.

2000

Yes – What was this firm’s e-commerce revenue? . . . . . $. . . . . . .
No – Go to 9

$
Month

Year

0010

When did this firm begin e-commerce sales?. . . . . . . . . . . . . . . .

9 Export Revenue
An exported service is a service performed for a customer or client (individual, government, business establishment, etc.) located
outside the United States (i.e., outside the 50 States, District of Columbia, U.S. Commonwealth Territories, or U.S. possessions).
Include:
• Revenue from the sale of personal, business, or mainframe computer software to clients and customers located outside the
United States.
• Services performed for unaffiliated and affiliated foreign firms (i.e., foreign parent firms, subsidiaries, branches, etc.).
Exclude:
• Services provided to domestic subsidiaries of foreign firms.
Did the revenue reported in 4 include any revenue
from exports?
1
0009
2

Yes – What was this firm’s revenue from exports?
No – Go to 11

10 Not Applicable

FORM asr_ef_05 (10-12-2005)

Bil.

2005 Export Revenue
Mil.
Thou.
Dol.

Bil.

2100

. . . . $. . . . . . .

$

2004 Export Revenue
Mil.
Thou.
Dol.

Page 7

11 Ownership or Control
Does another firm own more than 50 percent of the voting stock or have the power to control the management and
policies of this company?
0014

0013

1
2

Name of owning or controlling company

Yes – Provide this firm’s information. . . . .
0015
No – Go to 12

–

EIN
Street address

City, State, ZIP Code

12 Acquisitions or Mergers
Did this company acquire or merge with another firm in 2005 or 2004?

Month

Year

0018
1

Yes – Provide the date of the merger or acquisition and the firm’s information. . . . . . . . . . .
(for multiple mergers, provide each firm’s information as an attachment to this report)

2

No – Go to 13

0016

0017 Name of company acquired or merged with

0019

–

EIN
Street address

City, State, ZIP Code

13 Remarks –

Please provide an explanation for any inconsistent or incomplete data that would aid in understanding this report.
For any separate correspondence pertaining to this report, please include the identification number shown in the
address label area at the top of the first page.

0027

14 Certification – This report is substantially accurate and has been prepared in accordance with the instructions.
0020 Name of person completing this report – Please print

0024 Title

0025 Date

0021 Address (Street address, City, State, ZIP Code)

0022 Telephone number
Area code
Number

Return Completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
or fax to: 1–800–447–4613

Extension

0023 Fax number
Area code
Number

0026 E-mail address
Extension

Public reporting burden for this collection of information is estimated to average 3.0 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: Paperwork Project 0607-0422, U.S. Census Bureau, 4700
Silver Hill Road, Stop 1500, Washington, DC 20233-1500. You may e-mail comments to [email protected]; use
"Paperwork Project 0607-0422" as the subject. Please include form name and number in all correspondence. Respondents
are not required to respond to any information collection unless it displays a valid approval number from the Office of
Management and Budget. This 8-digit number appears in the top right corner on the front of this form.

To see aggregate industry results of previous Service Annual Surveys, go to the following website: www.census.gov/econ/www/servmenu.html
FORM asr_z_05 (1-11-2006)

2005 Annual Services Report
Instructions for Taxable Firms

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

General Instructions
•

Report data on an accrual basis, except for payroll.

•

Dollars should be rounded to the nearest dollar.

Bil.

•

If a figure is $1,030,280,456 it should be reported as

1

Mil.

Thou.

Dol.

030 280 456

Include in operating revenue:

•

Report gross billings, except where noted elsewhere on the form.

•

Amounts received for work subcontracted to others.

•

For locations that were sold or acquired during a year, only report for the periods that this firm operated the locations.

•

Revenue from services performed by domestic locations of foreign parent firms, subsidiaries, branches, etc.

•

Dues and assessments from members and affiliates.

Exclude from operating revenue:

•

Taxes collected directly from customers or clients and paid directly to a local, state, or federal tax agency.

•

Rents from and revenue of separately operated departments, concessions, etc., which are leased to others.

•

Commissions from vending machine operators.

•

Revenue of foreign subsidiaries (those located outside the U.S., i.e., outside the 50 states, District of Columbia, U.S.
Commonwealth Territories, or U.S. Possessions).

•

Non-operating revenue such as income from investments, sales of company-owned real estate (land and building), or other
assets, (except inventory held for resale, securities, gifts, loans, contributions, or grants).

•

Revenue from the sale of used equipment.

Item Specific Instructions
Item 6 – Operating Expenses
Line 1 – Gross annual payroll
Include salaries and wages, commissions, dismissal pay, bonuses, employee contributions to Social Security, income tax
withholding, union dues, group insurance premiums, savings bonds, cash equivalent in-kind, allowances, holiday pay,
vacation pay, sick leave, stock purchase plans, and employee contributions to pension plans. Exclude the cost of leased
employees, employer’s cost for fringe benefits, temporary staff obtained from temporary help services. For unincorporated
businesses, exclude profit or other compensation of proprietors or partners.

All other operating expenses
Include travel and entertainment; postage, shipping or delivery services, warehousing, and storage services; royalties;
security services; janitorial and grounds maintenance services; purchased transportation with operators; and other expenses
not reported elsewhere.

FORM asr_w_05 (1-11-2006)

USCENSUSBUREAU