BLS-1810A Facesheet Item information continuation sheet

Bureau of labor Statistics
Producer Price Indexes Facesheet
The Bureau of Labor Statistics,
information

in confidence

its employees,

collection,

by law. In accordance

the data needed,

including suggestions

Avenue, N.E., Wash., DC 20212.

with the Confidential

Federal laws, your responses will not be disclosed

by law 29 U.S.C 2. Your voluntary cooperation

Public reporting burden for this collection
and maintaining

agents, and partner statistical agencies, will use the information

to the full extent permitted

Public Law 107-347) and other applicable
This report is authorized

u.s. Departmentof labor

of information

is estimated

and reviewing the collection

Information

in identifiable

you provide for statistical

Protection

and Statistical

is needed to make the results of this survey comprehensive,

to average 2 hours, including time for reviewing instructions,

of information.

If you have any comments

You are not required to respond to this collection

Sample:

purposes only and will hold the

Efficiency Act of 2002 ( Title 5 of

accurate, and timely.
searching

regarding this estimate

existing data sources, gathering

or any other aspect of this information

Producer Price Index Program,

1220-0008,

unless it displays a currently valid OMB control number.

# Items:

Strata:

Sample NAIC:

NAIC Title:
CERTAINTY UNIT MAJOR PRODUCER PREY CYCLE INFORMATION

INFORMATION FOR SAMPLE UNIT/REPORTING UNIT
NAME:

REC CTR:
Street:

City:
State:
Zip:

Shipments

S&R Reference

& Receipts:

/

Date:
Mo.

Size Measure

Industry S&R Range: NAIC

BLS

- 1810A

(Revised June 200S)

Sampled

to

~~~

form without your informed consent.

for reducing this burden, please send them to the Bureau of Labor Statistics,

SU 10:

FormApproved

a.M.B. No. 1220-0008

Collected

RU S&R Ratio:

Yr.

2 Massachusetts

Shipments and Receipts Classified by NAIC
Product/Service

S&R

NAIC

Misc
Receipts:

%

Rank

999999

Collected NAIC:

ITEM INFORMATION
Disagg Same for All Items:
Item Item
Num Status MHF

MH
of

Rei
WT

Code
Disagg

I

01

Item Item
Num Status MHF
----, r-l
r-r1
07

MH
of
IT

Rei
WT

Disagg
Code

I

Num
Item Status
Item MHF

-----, r-l

-

13
-

02

08
-

14
-

03

09
10
11
12

04
05
06

Disagg Code:

J:

C:

Certainty Selection

Q:

Product Category Selection wiNO Disagg

COMMENTS

BLS -1810A (Revised June 2005)

Judgmental

rTl

MH
of

rn
Rei
WT

Disagg
Code

rr

15

-

16

-

i"

17
18

Selection

D:

R:

Refusal to Reselect

Default Disaggregation

T:

P:

Product Category Selection wlat least 1 step Disagg

Truncation Refusal Prior to Disagg

U:

ISDWS Disagg to a Unique Prod

Bureau of Labor Statistics
Producer Price Indexes.
Addltlonallnformatlon/Questlons

and Procedures Form

The Bureau of Labor Statistics willuse the information you
provide for statistical purposes only and will hold the infonnation
in confidence to the full extent pennitted by law.

.

U.S. Department of Labor

This report is authorized by law 29 U.S.C 2. Your voluntary
cooperation is needed to make the results of this survey
comprehensive. accurate. and timely.

Form Approved
a.M.B. No. 1220-0008

Public reporting burden for this collection of infonnation is estimated to average 2 hours. including time for reviewing instructions. searching existing data sources. gathering
and maintaining the data needed. and reviewing the collection of infonnation. If you have any comments regarding this estimate or any other aspect of this information
collection. including suggestions for reducing this burden, please send them to the Bureau of Labor Statistics. Producer Price Index Program. 1220-0008.2 Massachusetts
Avenue. N.E.. Wash.. DC 20212. You are not required to respond to this collection unless it displays a currently valid OMB control number.

SU 10: 2033--0008
INFORMATION FOR SAMPLE UNIT
Cluster ID:
Date Collected:
SU Status:

Source SU Type:
Date Interview:

Combined SU ID:

AUTH OFFICIAL

Phone:

Title:

Name:
CONTACT OFFICIAL

Name: -_.'

Title:
Date:

Phone:
SU COMMENTS

PREVIOUS CYCLE INFORMATION
Previous SU ID: 20330742

Previous SU Status:

Sample Overlap Reporter Code: 20330197

Name:
Street:
City:

State:

Zip:

Collected SIC:
Collected NAtC:
Date Collected:
INDUSTRY SPECIFIC QUESTIONS/PROCEDURES

CD
POST STRATA: