Various Economic Area Pretesting Activities

Generic Clearence for Questionnaire Pretesting Research

omb1108CFSenc1

Various Economic Area Pretesting Activities

OMB: 0607-0725

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07201015

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

2012 Commodity Flow Survey

FORM

CFS-2000 (2012)
(02-18-2011) Draft 1

OMB No. xxxx-xxxx: Approval Expires xx/xx/xxxx

DUE DATE:

YOUR RESPONSE IS REQUIRED
BY LAW. Title 13, United States
Code, requires businesses and
other organizations that receive
this questionnaire to answer the
questions and return the report to
the U.S.Census Bureau. By the
same law, YOUR REPORT IS
CONFIDENTIAL. It may be seen
only by persons sworn to uphold
the confidentiality of Census
Bureau information and may be
used only for statistical purposes.
Further, copies retained in
respondents’ files are immune
from legal process.

Please make corrections to name, address, and ZIP code if necessary.

INSTRUCTIONS:

• Please refer to the accompanying Instruction Guide for help in answering specific questions.
• More information is available at www.census.gov/cfs or at 1-800-772-7851.
PURPOSE OF THIS SURVEY: To develop information on the characteristics of freight flows in the United States.
The information you provide is critical to understanding transportation markets, investment needs and the economic, energy,
safety, and security consequences of transportation.

Item A

VERIFICATION OF PHYSICAL LOCATION

Verify the address listed above is the location from which this establishment’s shipments originate.
If corrections/additions are necessary, then make them directly to the address label above.

Item B

MAILING ADDRESS

a. What address should the 2012 CFS questionnaire be mailed to?
1

Mail the 2012 CFS questionnaire to this establishment’s physical location. (Proceed to Item C.)

Mail the 2012 CFS questionnaire to the address entered below.

b. Enter your mailing address.
Company Name 1

Company Name 2

Address

City

State

ZIP Code + 4

USCENSUSBUREAU

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Item C

OPERATING STATUS

Which of the following best describes this establishment’s operating status during the week of

In operation

Temporarily or seasonally inactive

Ceased operation - Enter date ceased operation

Item D

Date (MM-DD-YYYY)

➤

TOTAL NUMBER OF OUTBOUND SHIPMENTS

For this survey, it is important to obtain information about a sample of the outbound shipments made from this
establishment.
An outbound shipment in this survey is defined as a movement of commodities from your establishment to
another single location. If a truck makes multiple stops on a delivery route, please count each stop as one
shipment.
•
•

Remember to include only outbound shipments from your physical location (label address or
physical location in Item B).
Also include customer pick-ups, parcels, and all other outbound shipments.

1. What was the total number of all outbound shipments for this establishment the week of
Total number of outbound shipments

...................

Estimates are acceptable.
For further information, refer to the Instruction Guide, page 2.

2. Did you enter 40 or fewer shipments above?
1

Yes - Skip Item E and report all outbound shipments in Item F, pages 4-7.

No - Continue with Item E, on page 3.

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Item E

SAMPLING INSTRUCTIONS

In order to avoid asking you for information regarding all of your shipments, we will only ask about a sample of
them. This section will help you identify your sample of shipments.
1. Using the table below, mark the row that includes the total number of outbound shipments reported in
Item D, and the corresponding "report every" number.
Number of outbound
shipments reported in Line 1

Mark
(X) one

Report every...

1-40

Report every outbound shipment

41-80

Report every 2nd outbound shipment

81-100

Report every 3rd outbound shipment

101-200

Report every 5th outbound shipment

201-400

Report every 10th outbound shipment

401-800

Report every 20th outbound shipment

801-1600

Report every 40th outbound shipment

1601-3200

Report every 80th outbound shipment

3201-6400

Report every 160th outbound shipment

6401-12800

Report every 320th outbound shipment

More than 12800

Call Census at 1-800-772-7851 or
go to www.census.gov/cfs

2. Using your full set of shipments records for the week named in Item D, follow the steps below.
Step
Step
Step
Step
Step
Step
Step

1.
2.
3.
4.
5.
6.
7.

Count until you reach the "report every" number marked above.
Select that record.
Report that record in Line 1 of Item F, pages 4-5.
Continuing with the next shipment record, count until you reach the "report every" number again.
Select that record.
Report in Line 2 of Item F, pages 4-5.
Repeat this process until you have gone through your full set of shipment records.

3. Report these selected shipments in Item F.
Example:

If an establishment reported 150 shipments in Item D, it would correspond to the
range of 101-200 in the table above, and every 5th outbound shipment record would
be selected. This means the establishment would count 5 shipment records, select
that record, and report it in Item F. Continuing with the next shipment record, the
establishment would count 5 shipment records again, select that record, and report it
in Item F. The establishment would repeat this until it had gone through the full set
of shipment records for the week named in Item D.

For further information, refer to the Instruction Guide, page 3.

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Item F

SHIPMENT CHARACTERISTICS

(C)

Shipment value
(excluding
shipping costs)
in whole dollars.
Estimates
acceptable.

Net
Shipment Weight
in pounds

SCTG
commodity
code from
accompanying
booklet

(E)

(F)

(G)

Commodity Description

(D)

123-5

224,235

4840

34520

Mechanical machinery

402H

1,375

50,125

20222

Sulfuric acid

(A)

(B)

If a
hazardous
material,
enter the
"UN" or
"NA"
number
(H)

Continue with
column (I) on page 5

Shipment
Date

Day

Your
Shipment
ID
Number

Month

Line No.

NOTE: Each line runs across pages 4 and 5. After entering column H data on page 4
for any line, continue with column (I) on page 5 for the same line.

➜
1830

➜

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City

State

ZIP Code

(J)

(K) (L)

Los Angeles

90040

2, 4

Y Y

Newark

07105

N N

Foreign Destination
(for export shipments only)
Note: In column (I) enter the U.S. port,
airport, or border crossing of exit.
(M)
City

Country

Beijing

China

Line No.

(I)

Mode(s) of
transport to
U.S. destination.
Enter all that
apply in
order used.
Use codes
at bottom.

Export mode

U.S. Destination
or U.S. Exit Port
(Complete for all shipments.)

Temperature
controlled? (Y/N)
Export? (Y/N)

(N) (O)

0
00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Mode of transport codes for columns (J) and (N):
1 - Parcel delivery, courier,
4 - Railroad
or U.S. Parcel Post
5 - Shallow draft vessel
2 - Private truck
6 - Deep draft vessel
3 - For-hire truck
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7
8
9
0

Pipeline
Air
Other mode
Unknown

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Item F

SHIPMENT CHARACTERISTICS - Continued

(B)

(C)

(D)

Net
Shipment Weight
in pounds

SCTG
Commodity
Code from
accompanying
booklet

(E)

(F)

Commodity Description

If a
hazardous
material,
enter the
"UN" or
"NA"

(G)

(H)

Continue with
column (I) on page 7

Shipment
Date

Shipment value
(excluding
shipping costs)
in whole
dollars.
Estimates
acceptable.

Day

(A)

Your
Shipment
ID
Number

Month

Line No.

NOTE: Each line runs across pages 6 and 7. After entering column H data on page 6
for any line, continue with column (I) on page 7 for the same line.

➜

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City

State

ZIP Code

(J)

(K) (L)

(M)
City

Country

Line No.

Foreign Destination
(for export shipments only)
Note: In column (I) enter the U.S. port,
airport, or border crossing of exit.

Export mode

(I)

Export? (Y/N)

U.S.Destination
or U.S. Exit Port
(Complete for all shipments.)

Mode(s) of
transport to
U.S. destination.
Enter all that
apply in
order used.
Use codes
at bottom.

Temperature
controlled? (Y/N)

(N) (O)

21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
Mode of transport codes for columns (J) and (N):
1 - Parcel delivery, courier,
4 - Railroad
or U.S. Parcel Post
5 - Shallow draft vessel
2 - Private truck
6 - Deep draft vessel
3 - For-hire truck
Form CFS-2000

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7
8
9
0

Pipeline
Air
Other mode
Unknown

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Item G

MONTHLY VALUE OF OUTBOUND SHIPMENTS

Which of the following represents your best estimate of the total value of all outbound shipments
originating from this establishment for the most recently completed month?
1

Less than $1 Million

$40 Million or more but less than $100 Million

$1 Million or more but less than $10 Million

$100 Million or more but less than $400 Million

$10 Million or more but less than $40 Million

$400 Million or more

Item H

TIME SENSITIVE SHIPMENTS

Are shipments from this establishment time sensitive?

Yes

a. If yes, select each level of service that applies and select the percentage of shipments that use this
service:
Level of Service
1

Same Day/Overnight
1 to 25%

51 to 75%

76 to 100%

26 to 50%

51 to 75%

76 to 100%

26 to 50%

51 to 75%

76 to 100%

2-3 Business Days
1 to 25%

26 to 50%

4 Business Days or longer
1 to 25%

Contact Please provide the information below for the contact person regarding this report.
Name - Please print

Title - Please print

Signature

Area Code

Phone Number

Extension

Remarks Please use this space to clarify your responses, if appropriate.

Please return this survey in the enclosed envelope or send it to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville IN 47132-0001
THANK YOU FOR COMPLETING THIS REPORT.
Form CFS-2000

(02-18-2011) Draft 1

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File Type	application/pdf
File Title	CFS2000_p01_12.g
File Modified	2011-03-02
File Created	2011-02-18