Trade Adjustment Assistance for Firms

Form ED-840P
OMB Control No. 0610-0091
Expires:

iii

Economic Development Administration
PETITION BY A FIRM FOR CERTIFICATION OF ELIGIBILITY
TO APPLY FOR TRADE ADJUSTMENT ASSISTANCE
The Trade Adjustment Assistance for Firms Program (the “TAA Program”) is authorized by
chapters 3 and 5 of title II the Trade Act of 1974, as amended (19 U.S.C. § 2341 et seq.) (the
“Trade Act”). The TAA Program provides technical assistance to help U.S. firms experiencing a
decline in sales and employment, resulting in important part from the increase in imports of like or
directly competitive articles, to become more competitive in the global marketplace. The Secretary
of Commerce is responsible for administering the TAA Program and has delegated the statutory
authority and responsibility under the Trade Act to the U.S. Department of Commerce’s Economic
Development Administration (“EDA”). EDA regulations implementing the TAA Program are
codified at 13 C.F.R. part 315 and may be accessed via EDA’s Internet website at:
http://www.eda.gov.
For additional information on the TAA Program or to find the Trade Adjustment Assistance
Center (“TAAC”) serving your geographic region, please visit the Trade Adjustment
Assistance for Firms Internet website at: http://www.taacenters.org.

Petition By A Firm For Certification of Eligibility
To Apply For Trade Adjustment Assistance (Form ED-840P)
OMB Control No. 0610-0091
Expires:
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 of 1995, as amended,
unless the collection of information displays a currently valid OMB Control Number.
The information requested in the Petition by a Firm For Certification of Eligibility to Apply for Trade Adjustment Assistance (Form
ED-840P) is required to obtain or retain benefits from the Economic Development Administration (EDA) pursuant to chapters 3 and 5
of title II the Trade Act of 1974, as amended (19 U.S.C. 2341 et seq.). EDA uses information collected on Form ED-840P and in
accompanying documents to determine if a firm is eligible to apply for Trade Adjustment Assistance. The information
submitted on Form ED-840P and in accompanying documents is subject to public disclosure under the Freedom of Information Act,
unless exempt from disclosure as trade secrets or privileged or confidential commercial or financial information under 5 U.S.C. §
552(b)(4).
The public reporting burden for this collection of information is estimated to average 8 hours per response, including time for
reviewing instructions, gathering data and completing the Form ED-840P. Comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing paperwork burden may be sent to: U.S. Department of
Commerce, Economic Development Administration, TAA Program Manager, 1401 Constitution Avenue N.W., Room 7009,
Washington, D.C. 20230, and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington,
D.C. 20503.

GENERAL INSTRUCTIONS
NUMBER OF COPIES: Submit one (1) original, signed copy of the petition and any attachments to the address
provided at the top of the Petition by a Firm for Certification of Eligibility to Apply for Trade Adjustment Assistance
(Form ED-840P). EDA’s acceptance of a petition will be delayed if the Form ED-840P and the appropriate supporting
documentation are not completed in accordance with these instructions.
ELIGIBILITY: A petitioning firm must complete and file a Form ED-840P in order for EDA to determine its eligibility
to apply for Trade Adjustment Assistance. For purposes of determining eligibility, a firm, together with any predecessor
or successor firms, subsidiary firms, or any affiliated firms beneficially owned or controlled by substantially the same
person or persons, may be considered a single firm (petitioner) when they produce like or directly competitive articles or
are exerting essential economic control over one or more production facilities. See the definition of “Significant Number
or Proportion of Workers" in 13 C.F.R. § 315.2.
To establish eligibility, a firm must demonstrate the following: (i) a significant number or proportion of the workers in
the firm have been (or are threatened with becoming) totally or partially separated; (ii) sales or production, or both, of the
firm have decreased absolutely (or sales and production of an article accounting for at least 25 percent of the firm’s sales
or production during the two most recent consecutive twelve-month periods for which data are available have decreased
absolutely; this is otherwise known as the "25 percent" rule); and (iii) increases of imports of articles like or directly
competitive with those produced by the firm have contributed importantly to the separation (or threat of separation) and
to the decline in sales or production. In some cases, an interim decline in sales or employment may be used to satisfy the
eligibility requirements. See 13 C.F.R. § 315.7 for a detailed explanation of the certification requirements.
ITEM 3 – RELATED FIRMS: Provide the name and address of any subsidiary, affiliate, predecessor or successor
firm, co-venturer, and any other related firm. In addition, describe (if applicable) the ownership of each of the related
firms (including the names of the owners and their respective ownership percentages), the relationship of the firms to
each other, the type of business each firm is engaged in, the nature and amount of any intercompany transactions, and
indicate whether each related firm is currently conducting business. Information about a related firm should be included
as part of the petition whether or not (i) such firm’s operations are related to the activities of the petitioner, (ii) its
activities have been affected by import competition, or (iii) it is engaged in manufacturing activities.
ITEM 4 – HISTORY OF PETITIONING FIRM: Please attach a narrative discussing (at a minimum) the following
items as each pertains to the petitioning firm:
(a)
(b)
(c)
(d)
(e)
(f)
(h)
(i)
(j)

Year founded;
Type of business;
A detailed description of all goods produced, articles sold and services provided;
Number, location, and nature of business of all manufacturing, production, distribution and sales facilities, both
domestic and foreign;
Markets served by the petitioning firm;
Names and titles of officers, directors, and senior management of the petitioning firm;
Significant ownership or management changes in the past 5 years;
Important events in the recent history of the petitioning firm, such as but not limited to natural disasters, fires,
labor strikes, changes in product mix; and
Any other information germane to the petition.

ITEM 6 – SALES/PRODUCTION DATA: Provide sales/production data for the period covered by the petition. The
period covered by the petition must not end more than 120 days prior to the date the petition is submitted to EDA for
investigation. If a firm has export or other foreign sales or productions operations, attach a separate sheet describing the
foreign output and employment data separately from domestic output and employment data. List only net sales “F.O.B.
Point of Shipment” and exclude interplant transfers, returned goods, discounts, and other intercompany transactions or
allowances.
ITEM 7 – IMPORT DATA: Provide the U.S. Harmonized Tariff Schedule (“HTS”) number and basket description for
each like or directly competitive import-impacted article identified in Item 6. Also provide the total value (in thousands
of U.S. dollars) of the imported articles attributable to each HTS number.

(General Instructions continued)
ITEM 8 – EMPLOYMENT DATA: Calculate the total average monthly employment for all of the petitioning firm’s
employees for the entire period covered by the petition. Separately calculate the total average monthly employment for
all production and related workers for all import-impacted articles reported in Item 6. Monthly employment generally
includes both full- and part-time employees. See 13 C.F.R. §§ 315.2 and 315.7. If any group of employees of the
petitioning firm has petitioned the U.S. Department of Labor for certification of eligibility to apply for trade adjustment
assistance for workers, you may authorize the release to the U.S. Department of Commerce of any information obtained
by the U.S. Department of Labor during its investigation of the worker’s case by calling the U.S. Department of Labor,
Division of Trade Adjustment Assistance, at (202) 693-3560 or by a letter of authorization. The letter should be
addressed and mailed to the Director, Division of Trade Adjustment Assistance, Room C-5311, Employment and
Training Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. Please
include a copy of your letter with this petition. Access to the U.S. Department of Labor records may expedite the
processing of this petition.