BE-11 Claim for Not Filing

FORM

BE-11 Claim for Not Filing (REV. 7/2010)

OMB No. 0608-0053: Approval Expires 01/31/2012

MANDATORY — CONFIDENTIAL
2010 ANNUAL SURVEY OF U.S. DIRECT INVESTMENT ABROAD
BE-11 (Claim for Not Filing)
MAIL REPORTS TO:
U.S. Department of Commerce
Bureau of Economic Analysis
BE-69(A)
Washington, DC 20230
OR

BEA USE ONLY Reporter ID Number
Name and address of U.S. business enterprise for which this claim is filed — If the enterprise
received a Form BE-11A but is exempt from filing, enter below the Reporter name, address, and BEA
assigned Identification Number (Reporter ID) from the preprinted information provided in Part I, item 1,
of Form BE-11A. If a Form BE-11A was not received, enter name and address.
Name and address of U.S. Reporter

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-11, 2010 Annual Survey of U.S. Direct Investment Abroad, 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 the end of its 2010 fiscal year, unless all
of the person’s affiliates are exempt. (The U.S. person’s 2010
fiscal year is defined to be the person’s financial reporting year
that has an ending date in calendar year 2010.)
Section 806.4 of 15 CFR, Chapter VIII, requires that all persons
subject to the reporting requirements of the BE-11 survey
respond, whether or not they are contacted by BEA.

It also requires that all 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-11 report by May 31,
2011, as required;
completing and returning the "BE-11 Claim for Not
Filing" by May 31, 2011;
certifying in writing, by May 31, 2011, to the fact that the
person had no direct investment within the purview of the
reporting requirements of the BE-11 survey.

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 the end of its 2010 fiscal year.
But did file the 2009 BE-11, Annual Survey of U.S. Direct Investment Abroad, 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) at the end of its 2010 fiscal year, but (Mark (X) one) –
1

None of its foreign affiliates are required to be reported on Forms BE-11B(LF), (SF), (FN) or (EZ) or Form BE-11C, because all
affiliates are exempt. You must complete the reverse side of this claim for those affiliates for which you received
a preprinted form. See Instruction Booklet, Section I.C., for exemption criteria.

2

Is fully consolidated in the BE-11 report for
another U.S. person – Give name and
address of that person and their BEA
Identification Number, if known.

Name
Address – Number and street or P.O. Box
City
BEA Identification
Number

C.

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

State

ZIP Code

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. These civil penalties are subject to inflationary adjustments. Those adjustments are found in
15 CFR 6.4.
PERSON TO CONSULT CONCERNING QUESTIONS ABOUT
THIS REPORT
Name

CERTIFICATION – The undersigned official certifies that the
information contained in this claim is correct and complete to the best
of his/her knowledge.
Authorized official’s signature

Address

Date

Print or type name and title
Area code

Number

Extension

Telephone
Area code
FAX Number

Telephone

E-mail Address

FAX Number

Number

Extension

If you are claiming exemption based upon the criteria in B.1 (see the reverse side of this claim), complete the items below for those
affiliates for which you received preprinted forms. Copy the affiliate name and affiliate ID from the preprinted form and complete the
remaining items.
1 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)

2 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)

Remarks

FORM BE-11 Claim for Not Filing (REV. 7/2010)

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If you are claiming exemption based upon the criteria in B.1 (see the reverse side of this claim), complete the items below for those
affiliates for which you received preprinted forms. Copy the affiliate name and affiliate ID from the preprinted form and complete the
remaining items. — Continued
3 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)

4 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)

5 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)

6 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2010 – Enter to the
nearest tenth of one percent

___ ___ ___ . ___ %
Amount
(Thousands of U.S. dollars)

b. Total assets – Balance at
close of fiscal year
Affiliate ID:

c. Annual sales or gross operating
revenues, excluding sales taxes
d. Net income (loss)
Additional foreign affiliates should be reported on additional copied sheets.

Remarks

FORM BE-11 Claim for Not Filing (REV. 7/2010)

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