Various Economic Pretesting Activities

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

General Classification Report

FORM

NC-99023

2012 ECONOMIC CENSUS
OMB No. 0607-0924: Approval Expires 4/30/2014

(05-03-2011)

(Please correct any errors in this mailing address.)

DUE DATE
30 DAYS AFTER RECEIPT
Need help or have questions?
Visit www.census.gov/econhelp/classforms

NC-99023

- OR -

Call 1-800-233-6136, between 8:00 a.m. and 5:00 p.m.,
Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN)
printed in the mailing address with all communications.

Report Online - It's accurate and secure!
Go to: www.census.gov/econhelp/classforms

Mail your completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001

- OR -

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 CENSUS 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.
• Use blue or black ink.
• Do not use pencil.
• Place an "X" inside the box.
1

• Please center numbers in their respective boxes. Examples:
• Do not put slashes through 0 or 7.
• Complete only the unshaded portion of each item.

PHYSICAL LOCATION
A. Is this establishment's physical location the same as shown in the mailing address?
(P.O. box and rural route addresses are not physical locations.)
0031

99023012

0032

Yes - Go to line B
No Enter
physical
location

0035

Number and street

0036

City, town, village, etc.

0037 State

0038

ZIP Code

B. Is this establishment physically located inside the legal boundaries of the city, town, village,
etc.? (Mark "X" only ONE box.)
0041

Yes

0042

No

0043

No legal boundaries

0044

Do not know

C. In what type of municipality is this establishment physically located? (Mark "X" only ONE box.)
0229

City, village, or borough

PENALTY FOR FAILURE TO REPORT

USCENSUSBUREAU

0230

Town or township

0231

Other

0232

Do not know
CONTINUE ON PAGE 2

Form NC-99023
2

Page 2

(05-03-2011)

PRINCIPAL BUSINESS OR ACTIVITY
In the past 12 months, what was this establishment's principal business or activity? (Find the Economic Sector
that best describes your business or activity. Within that sector, mark "X" only ONE box that best describes your
PRINCIPAL business or activity.)

0700

99023020

REAL ESTATE AND RENTAL AND LEASING

HEALTH CARE AND SOCIAL ASSISTANCE

531 210 10 1

Real Estate Agent or Broker, Residential

621 111 00 1

Office of Physician (MD or DO), except
Mental Health

531 210 90 1

Real Estate Agent or Broker, Nonresidential

621 112 00 1

Office of Physician (MD or DO), Mental
Health

531 130 00 1

Lessor of Self-Storage Units

621 330 00 1

Office of Mental Health Practitioner,
except Physician

531 110 10 1

Lessor of Apartment Buildings

621 210 00 1

Office of Dentist

531 110 90 1

Lessor of Residential Buildings, except
Apartments

621 310 00 1

Office of Chiropractor

531 120 30 1

Lessor of Shopping Centers and Retail Stores

621 320 00 1

Office of Optometrist

531 120 10 1

Lessor of Professional and Other Office
Buildings

621 391 00 1

Office of Podiatrist

531 120 20 1

Lessor of Manufacturing and Industrial
Buildings

621 340 20 1

Office of Physical and Occupational
Therapist

531 120 90 1

Lessor of Other Nonresidential Buildings

621 340 10 1

Office of Speech Therapist and
Audiologist

531 190 10 1

Lessor of Manufactured (Mobile) Home Sites

624 410 00 1

Child Day Care Services

531 311 00 1

Property Management, Residential

624 120 00 1

Social Assistance for Elderly and Disabled

531 312 00 1

Property Management, Nonresidential

624 110 00 1

Social Assistance for Children and Youth

531 320 00 1

Real Estate Appraisal Services

624 210 00 1

Community Food Services

532 310 00 1

General Rental Center

624 221 00 1

Temporary Shelter

532 292 00 2

ATV, Motorcycle, and Personal Watercraft
Rental

624 229 00 1

Community Housing Services

532 120 90 1

Recreational Vehicle (RV) Rental

624 310 00 1

Vocational Rehabilitation Services

532 292 00 1

Recreational Goods Rental

623 311 00 1

Continuing Care Retirement Community

532 412 90 1

Oilfield and Well Drilling Equipment Rental and
Leasing

623 312 00 1

Home for the Elderly Without Nursing
Care

532 412 10 1

Heavy Construction Equipment Rental and
Leasing

623 110 00 1

Nursing Care Facility

532 111 00 1

Car Rental (Passenger) Without Driver

623 210 00 1

Residential Facility for Developmentally
Disabled

532 120 10 1

Truck Rental (Nonpassenger) Without Driver

623 220 00 1

Residential Mental Health and Substance
Abuse Facility

532 490 20 1

Industrial Equipment Rental and Leasing

621 610 00 1

Home Health Care Services

532 291 00 1

Home Health Equipment Rental

621 512 00 1

Diagnostic Imaging Center

532 490 10 1

Medical Equipment Rental and Leasing

621 910 00 1

Ambulance or Rescue Services

532 420 90 1

Computer Equipment Rental and Leasing

620 000 00 7

Other Health Care and Social Assistance Specify

532 420 10 1

Office Equipment Rental and Leasing

777 530 00 3

Other Real Estate and Rental and Leasing Specify

CONTINUE ON PAGE 3

Form NC-99023

Page 3

(05-03-2011)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
2

PRINCIPAL BUSINESS OR ACTIVITY - Continued

0700

REPAIR AND MAINTENANCE SERVICES
811 111 00 1

General Automotive Repair

524 210 00 1

Insurance Agency or Brokerage

811 121 10 1

Paint or Body Repair

524 291 00 1

Claims Adjusting

811 113 00 1

Automotive Transmission Repair

524 292 00 1

Third-Party Administration of Insurance
Funds

811 191 00 1

Automotive Oil Change and Lubrication

524 292 00 2

Third-Party Administration of Pension
and Benefit Funds

811 112 00 1

Automotive Exhaust System Repair

523 930 00 1

Investment Advice Without Portfolio
Management

811 122 00 1

Automotive Glass Repair

523 120 00 1

Securities Brokerage

811 192 00 1

Car Wash

523 920 00 1

Portfolio Management

811 310 40 1

Welding Repair

522 310 00 1

Mortgage or Other Loan Brokerage

811 310 90 1

Commercial and Industrial Equipment Repair

522 292 90 1

Mortgage Lending

811 212 30 1

Computer Repair and Maintenance

520 000 00 1

Other Finance and Insurance - Specify

811 412 00 1

Appliance (Household) Repair and Maintenance

561 740 00 1

Carpet and Upholstery Cleaning Services

811 420 00 1

Reupholstery and Furniture Repair

561 720 00 1

Janitorial Services

722 110 00 1

Full-Service Restaurant (Waiter/Waitress
Service), Pay After Eating

561 730 00 1

Landscaping Services

722 212 00 1

Buffet, Grill Buffet, or Cafeteria

561 710 00 1

Exterminating and Pest Control Services

722 211 00 1

Limited-Service Restaurant (including
Delivery-Only Locations)

Other Repair and Maintenance Services Specify

722 410 00 1

Bar, Tavern, Pub, or Other Drinking Place
(Alcoholic Beverages)

722 320 00 1

Caterer for Banquets, Weddings, etc.

722 213 50 1

Coffee Shop

722 213 30 1

Donut Shop

811 000 00 5

PERSONAL CARE AND LAUNDRY SERVICES

99023038

FINANCE AND INSURANCE

FOOD SERVICES

812 112 00 1

Beauty Salon

722 213 40 1

Bagel Shop

812 113 00 1

Nail Salon

722 213 70 1

Bakery Cafe With Customer Seating

812 111 00 1

Barber Shop

311 811 00 1

Bakery Without Customer Seating

812 199 00 1

Tanning Salon

722 213 10 1

Ice Cream Shop

812 199 00 2

Tattoo Parlor

722 213 20 1

Frozen Yogurt Shop

812 310 20 1

Coin-Operated Laundry and Drycleaning

722 330 00 1

Mobile Food Services

812 320 20 1

Drycleaning Plant

722 310 00 1

Food Service Contractor

812 910 00 1

Pet Care Services, except Veterinary

722 000 00 2

Other Food Services - Specify

812 000 00 5

Other Personal Care and Laundry Services Specify

CONTINUE ON PAGE 4

Form NC-99023
2

Page 4

(05-03-2011)

PRINCIPAL BUSINESS OR ACTIVITY - Continued

0700

ACCOMMODATIONS
721 211 00 1

RV (Recreational Vehicle) Park or Campground,
except Residential

454 111 21 1

Internet Retailing Only, Computer
Hardware and/or Software

721 214 00 1

Recreation or Vacation Camp, except
Campground

454 111 22 1

Internet Retailing Only, Pharmacy

721 191 00 1

Bed-and-Breakfast Inn

454 111 23 1

Internet Retailing Only, Other Specialized
Merchandise

721 110 00 1

Hotel or Motel

454 111 10 1

Internet Retailing Only, General
Merchandise

721 000 00 2

Other Traveler Accommodations - Specify

454 113 22 1

Mail-Order Pharmacy

446 191 00 1

Health Supplement and Vitamin Store

446 110 00 1

Pharmacy and Drug Store

RETAIL TRADE

99023046

RETAIL TRADE - Continued

447 110 00 1

Gasoline Station With Convenience Store

446 120 00 1

Cosmetics, Beauty Supplies, and Perfume
Store

447 190 10 1

Gasoline Station Without Convenience Store

453 920 00 1

Art Dealer or Art Auction

445 120 00 1

Convenience Food Store

443 112 20 1

Cellphone Store

445 110 00 1

Grocery Store or Supermarket

443 120 20 1

Computer Store, except Custom
Assembly

445 310 00 1

Beer, Wine, or Liquor Store

443 120 10 1

Computer Store, Custom Assembly

445 210 00 1

Meat Market

443 112 40 1

Consumer Electronics Store

441 120 00 1

Car Dealer, Used Only

443 111 00 1

Household Appliance Store

441 110 00 1

Car Dealer, New and Used

444 130 00 1

Hardware Store

441 221 00 1

Motorcycle, ATV, and Personal Watercraft
Dealer

444 210 00 1

Outdoor Power Equipment Store

441 320 00 1

Tire Dealer

444 220 40 1

Nursery and Garden Center

441 310 50 1

Used Automotive Parts Store (Junk Yard)

444 220 20 1

Farm Supply Store

441 310 40 1

Automotive Parts and Accessories Store

453 210 00 1

Office Supplies and Stationery Store

448 140 00 1

Clothing Store, Family, New

451 110 10 1

Sporting Goods Store, General-Line

448 120 00 1

Clothing Store, Women's, New

453 991 00 1

Tobacco Store

448 110 00 1

Clothing Store, Men's, New

453 930 00 1

Manufactured (Mobile) Home Dealer

448 130 00 1

Clothing Store, Children's and Infants', New

453 910 00 1

Pet and Pet Supplies Store

448 150 00 1

Clothing Accessories Store, New

454 210 00 1

Vending Machine Operator

453 310 10 1

Antique Store

451 130 00 1

Sewing, Needlework, and Piece Goods
Store

522 298 10 1

Pawn Shop

451 120 20 1

Craft Supplies Store

453 310 20 1

Thrift or Consignment Store

451 120 10 1

Hobby, Toy, and Game Store

448 310 00 1

Jewelry Store, except Costume, New

453 220 00 1

Gift, Novelty, and Souvenir Store

442 110 10 1

Furniture Store, except Custom

772 000 00 1

Other Retail Business - Specify

442 210 00 1

Floor Coverings Store

453 110 00 1

Florist
CONTINUE ON PAGE 5

Form NC-99023

Page 5

(05-03-2011)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
2

PRINCIPAL BUSINESS OR ACTIVITY - Continued

0700

ADMINISTRATIVE AND SUPPORT SERVICES
561 510 00 1

Travel Agency

541 110 10 1

Lawyers' Office

561 612 00 1

Security Guards and Patrol Services

541 211 00 1

Certified Public Accountant (CPA) Office

561 622 00 1

Locksmith

541 213 00 1

Tax Return Preparation Services Only

561 621 00 1

Security Systems Services

541 219 00 1

Accounting and Bookkeeping Services

561 611 00 1

Investigation Services

541 330 00 1

Engineering Services

561 330 00 1

Professional Employer Organization (PEO)

541 310 00 1

Architectural Services, except Landscape

561 320 00 1

Temporary Help Services

541 320 00 1

Landscape Architectural Services

561 312 00 1

Executive Search Services

541 511 00 1

Custom Computer Programming Services

561 311 00 1

Employment Placement Agency

511 210 00 1

Software Publishing

561 410 00 1

Document Preparation Services

541 512 10 1

Computer Systems Integration

561 431 00 1

Private Mail Center

518 210 00 1

Data Storage, Processing, Hosting, and
Related Services

561 439 00 1

Photocopying and Duplicating Services

519 130 10 1

Publishing and Broadcasting, Internet
Only

561 110 00 1

Office Administrative Services

541 513 00 1

Computer Facilities Management

561 422 00 1

Telemarketing Bureau or Other Contact Center

541 512 20 1

Computer Systems Design Services

561 920 00 1

Convention and Trade Show Organizing

541 430 00 1

Graphic Design Services

561 990 30 1

Economic or Industrial Planning or
Development Organizing

541 410 00 1

Interior Design Services

561 000 00 4

Other Administrative and Support Services Specify

541 370 00 1

Surveying and Mapping Services, except
Geophysical

EDUCATIONAL SERVICES

99023053

PROFESSIONAL, SCIENTIFIC, AND TECHNICAL
SERVICES

541 360 00 1

Geophysical Surveying and Mapping
Services

541 620 00 1

Environmental Consulting Services

541 613 00 1

Marketing Consulting Services

611 420 00 1

Computer Training

541 612 30 1

Human Resources and Personnel
Management Consulting Services

611 430 00 1

Professional and Management Development
Training

541 614 00 1

Process, Physical Distribution, and
Logistics Consulting Services

611 691 00 1

Exam Preparation and Tutoring

541 611 00 1

Administrative and General Management
Consulting Services

611 710 20 1

Educational Test Development and Evaluation
Services

541 921 00 1

Photographic Studio, Portrait

611 710 10 1

Educational Support Services

541 922 00 1

Commercial Photography

610 000 00 1

Other Educational Services - Specify

512 110 00 1

Motion Picture or Video Production

541 000 00 7

Other Professional, Scientific, and
Technical Services - Specify

CONTINUE ON PAGE 6

Form NC-99023
2

99023061

0700

Page 6

(05-03-2011)

PRINCIPAL BUSINESS OR ACTIVITY - Continued
TRANSPORTATION

0700

WHOLESALE TRADE
(Mark "X" only ONE box in part 1 and ONE box in part 2.)
1. Kind of Business or Activity

484 121 00 1

General Freight Trucking, Long-Distance,
Truckload

484 122 00 1

General Freight Trucking, Long-Distance,
Less Than Truckload

423 110 10 1

Automobiles and Motorcycles

484 210 20 1

Used Household and Office Goods Moving,
Long-Distance

423 120 10 1

Motor Vehicle Parts, New

484 230 20 1

Agricultural Products Trucking, Long-Distance

423 210 10 1

Household and Outdoor Furniture

484 230 10 1

Hazardous Materials Trucking (except Waste),
Long-Distance

423 910 00 1

Sporting and Recreational Goods and
Supplies

484 230 30 1

Specialized Freight Trucking (including
Waste), Long-Distance

423 940 10 1

Jewelry, Watches, and Gemstones

562 112 00 1

Hazardous Waste Collection, Local

423 450 20 1

Dental Equipment and Supplies

562 111 00 1

Solid Waste Collection, Nonhazardous, Local

423 450 10 1

Surgical, Medical, and Hospital Equipment
and Supplies

484 220 10 1

Hazardous Materials Trucking (except Waste),
Local

423 430 12 1

Computers and Peripheral Equipment, Sold
for End Use

484 110 10 1

General Freight Trucking Without Storage,
Local, Truckload

423 430 11 1

Computers and Peripheral Equipment, Sold
for Resale

484 110 20 1

General Freight Trucking Without Storage,
Local, Less Than Truckload

423 620 90 1

Electrical and Electronic Appliance, TV, and
Radio

484 110 30 1

General Freight Trucking With Storage, Local,
Truckload

424 330 00 1

Women's, Children's, and Infants' Clothing
and Accessories

484 110 40 1

General Freight Trucking With Storage, Local,
Less Than Truckload

424 320 00 1

Men's and Boys' Clothing and Accessories

484 220 30 1

Dump Trucking

771 000 00 1

Other Wholesale Trade - Specify

484 220 20 1

Agricultural Products Trucking, Local

484 210 10 1

Used Household and Office Goods Moving,
Local, Without Storage

484 210 30 1

Used Household and Office Goods Moving,
Local, With Storage

11

Merchant Wholesaler

484 220 40 1

Specialized Freight Trucking (except Waste),
Local, Without Storage

46

Manufacturers' Agent

484 220 50 1

Specialized Freight Trucking (except Used
Goods), Local, With Storage

42

Broker, Representing Buyers and Sellers

488 510 10 1

Freight Forwarding

49

Electronic Marketer

488 510 20 1

Arrangement of Transportation of Freight
and Cargo

77

Other Type of Operation - Specify

485 320 00 1

Limousine Services

488 410 00 1

Towing Services, Motor Vehicle

485 991 00 1

Special Needs Transportation

492 210 00 1

Local Messenger and Local Delivery

492 110 10 1

Courier Services (except by Air)

485 999 20 1

Other Transportation - Specify

0600

0601

2. Type of Operation

CONTINUE ON PAGE 7

Form NC-99023

Page 7

(05-03-2011)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
2

PRINCIPAL BUSINESS OR ACTIVITY - Continued

0700

ARTS, ENTERTAINMENT, AND RECREATION

MANUFACTURING

713 940 90 1

Fitness Center or Gymnasium

332 710 00 1

Machine Shop

713 910 00 1

Golf Course or Country Club

323 114 00 1

Quick Printing

713 930 00 1

Marina

323 113 00 1

Commercial Screen Printing

713 120 00 1

Arcade or Family Fun Center

337 121 00 1

Upholstered Household Furniture
Manufacturing

611 620 00 1

Sports and Recreation Instruction

337 122 00 1

Nonupholstered Wood Household
Furniture Manufacturing

611 610 10 1

Dance School

339 950 00 1

Sign Manufacturing

611 610 20 1

Art, Drama, or Music School

339 116 00 1

Dental Laboratory

711 510 00 1

Actor/Actress, Artist, Writer, or Performer,
except Musician

339 990 00 1

Other Manufacturing - Specify

711 320 00 1

Promoter of Performing Arts, Sports, and
Similar Events Without Facilities

711 310 00 1

Promoter of Performing Arts, Sports, and
Similar Events With Facilities

CONSTRUCTION

Other Arts, Entertainment, and Recreation Specify

238 330 20 1

Flooring Contractor

236 118 00 1

Residential Remodeler

238 220 00 1

Plumbing Contractor

238 220 00 2

HVAC Contractor

774 000 00 1

99023079

CIVIC, PROFESSIONAL, AND SIMILAR ORGANIZATIONS
813 410 30 1

Scouting or Related Youth Development
Organization

236 115 00 1

New Single-Family Housing Construction
(Built on Land Customer Owns)

813 410 40 1

Civic or Social Club

236 117 00 1

New Housing Construction (Built on Land
You Own Or Control, For Sale)

813 990 40 1

Property Owners' Association

238 350 00 1

Carpentry Finishing Contractor

813 910 00 1

Business Trade Association

238 340 00 1

Tile, Marble, Terrazzo, and Mosaic
Contractor

813 920 00 1

Professional Organization

238 000 00 1

Other Construction - Specify

813 211 00 1

Grantmaking Foundation

813 312 00 1

Environment, Conservation, and Wildlife
Organization

OTHER

813 311 00 1

Human Rights Organization

523 991 00 1

Administrator of Private Estate

813 212 00 1

Voluntary Health Organization

523 991 00 2

Trustee in Bankruptcy

813 000 00 1

Other Similar Organization - Specify

525 920 00 1

Trust or Estate

813 110 00 1

Church or Other Religious Organization

814 110 00 1

Employer of Domestic Help (Cook, Maid,
Gardener, etc.), Private Household

773 000 00 2

Other Business or Activity - Specify

CONTINUE ON PAGE 8

Form NC-99023
3

Page 8

(05-03-2011)

CLASS OF CUSTOMER
A. Was a box marked under Retail Trade or Wholesale Trade headings in
Yes - Go to line B

0284

No - Go to

0285

2

?

4

B. As a general business practice, did this establishment sell to household consumers and individual users in the past
12 months?
Yes - Go to line C

0251

No - Go to line D

0252

C. Were 10 percent or more of your sales to household consumers and individual users in the past 12 months?
Yes

0288

No

0289

D. Were 75 percent or more of this establishment's sales to retailers or wholesalers for resale in the past 12 months?
Yes

0256

No

0257

E. Did this establishment require proof of business or professional license from new customers in the past 12 months?
Yes

0276

4

No

0277

DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE
Report sales for the principal merchandise lines sold, type of construction work done, products produced, or services
provided by this establishment as a whole percent of the total dollar volume of business (e.g., gasoline 85%, auto
repairs 10%, oil 5%) in the past 12 months.
Whole percent of
Census sales and receipts
in the past 12
use
months

Description of sales, shipments, receipts, or revenue
0723

0720

0722

1.

19811

2.

19812

3.

19813

4.

29811

%
%
%
%

5. TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

0

0 %

REMARKS (Please use this space for any explanations that may be essential in understanding your reported data.)

99023087

5

CERTIFICATION - This report is substantially accurate and was prepared in accordance with the instructions.
Title

Name of person to contact regarding this report

Area code
Telephone

Number

-

-

Extension

-

Area code

Fax

E-mail address

Number

Month

Day

Date
completed

Thank you for completing this 2012 ECONOMIC CENSUS form.
PLEASE PHOTOCOPY THIS FORM FOR YOUR RECORDS AND RETURN THE ORIGINAL.

Year