BE-10 Claim for No BE-10 Claim for Not Filing

OMB No. 0608-0049: Approval Expires 9/30/2007

BE-10 Claim for Not Filing
U.S. DEPARTMENT OF COMMERCE

2004 BENCHMARK SURVEY OF
U.S. DIRECT INVESTMENT ABROAD

Economic and Statistics Administration

BUREAU OF ECONOMIC ANALYSIS

FORM

MANDATORY — CONFIDENTIAL

BE-10 (Claim for Not Filing) (REV. 12/2004)

MAIL REPORTS TO:
U.S. Department of Commerce
Bureau of Economic Analysis
BE-69(A)
Washington, DC 20230

BEA USE ONLY

Reporter ID Number

1. Name and address of U.S. Reporter

OR
DELIVER REPORTS TO:
U.S. Department of Commerce
Bureau of Economic Analysis
BE-69(A)
Shipping and Receiving,
Section M-100
1441 L Street, NW
Washington, DC 20005
A BE-10, Benchmark Survey of U.S. Direct Investment Abroad — 2004, is required from any U.S. person that had a foreign affiliate — that is,
that had direct or indirect ownership or control of at least 10 percent of the voting stock of an incorporated foreign business enterprise or an
equivalent interest in an unincorporated foreign business enterprise — at any time during its 2004 fiscal year. (The U.S. person’s 2004 fiscal
year is defined to be the person’s financial reporting year that has an ending date in calendar year 2004.)
Section 806.4 of 15 CFR, Chapter VIII, requires that all persons subject to the reporting requirements of the BE-10 survey respond, whether or
not they are contacted by BEA.
It also requires that persons, or their agents, who are contacted by BEA about reporting in this survey, either by sending them report forms or
by written inquiry, must respond in writing. They may respond by:

•
•
•

filing the properly completed BE-10 report by May 31, or June 30, 2005, as required.
completing and returning the "BE-10 Claim for Not Filing" by May 31, 2005.
certifying in writing, by May 31, 2005, to the fact that the person had no direct investment within the purview of the reporting requirements
of the BE-10 survey;

For copies of BE-10 forms and instructions and the Guide to Industry Classifications for International Surveys, 2002, visit the BEA
Web site www.bea.gov. Contact us for help by telephone at 202-606-5566 or by e-mail be10/[email protected].
BASIS OF CLAIM FOR NOT FILING — Mark (X) and complete either A or B
A.

This U.S. person did not own or control, directly and/or indirectly, 10 percent or more of the voting securities of an incorporated
foreign business enterprise, or an equivalent interest in an unincorporated foreign business enterprise (including a branch or
real estate held for other than personal use) at any time during its 2004 fiscal year.
But did file a 2003 BE-11 Annual Survey of U.S. Direct Investment Abroad report with this Bureau.
And did not file a 2003 BE-11 Annual Survey of U.S. Direct Investment Abroad report with this Bureau.

B.

This U.S. person did own or control, directly or indirectly, 10 percent or more of the voting securities of an incorporated foreign
business enterprise, or an equivalent interest in an unincorporated foreign business enterprise (including a branch or real estate
held for other than personal use) during its 2004 fiscal year, but (Mark (X) one)
1

The owners are citizens of a foreign country who (a) are resident in the U.S. as a result of official employment by a foreign
government (including the immediate family of such persons), or (b) have been and expect to be resident in the U.S. for less
than one year.

2

Is fully consolidated in the BE-10
report of another U.S. person —
Give name and address of that
person and their BEA Identification
Number, if known.

Name

Address — Number and street or PO Box
State

City

ZIP Code

BEA Identification
Number
3

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

MANDATORY — This survey is being conducted under 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 under Section 5(b)(2) of the Act (22
U.S.C. 3104).
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.
PENALTIES — Whoever fails to report shall be subject to a civil penalty of not less than $2,500, and not more that $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 violations, upon 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.
PERSON TO CONSULT CONCERNING QUESTIONS ABOUT THIS
REPORT — Enter name and address
CERTIFICATION — The undersigned official certifies that the
informatin contained in this claim is correct and complete to the
best of his/her knowledge.

1

Name
Address

Authorized official’s signature
TELEPHONE
NUMBER

Area code

Number

Area code

Number

Extension

Print or type name and title
Telephone number

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

Date

1000

1

1

FAX number
E-mail address

1
2

Yes — If yes, please
provide your
e-mail address.
No

BE-10 (Claim for Not Filing) page 1, Pantone 3155 green, 10% and 100%

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