Form NC-99001 2011 Report of Organization

2009 -- 2011 Company Organization Survey

2011_NC-99001.draft_1

State & Local Government Burden

OMB: 0607-0444

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2011 REPORT OF ORGANIZATION

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

NC-99001

OMB No. 0607-0444: Approval Expires 10/31/2012

(DRAFT)

NC-99001

Need help or have questions about
filling out this form?
Visit www.census.gov/econhelp
- OR Write to the address below. Include
your 11-digit Census File Number (CFN)
printed in the mailing address.
Mail your completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001

(Please correct any errors in name and address, including ZIP Code.)

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.
The purpose of this form is to obtain an accurate and up-to-date list of your establishments, i.e., separate business locations
that were in operation or new plant(s) under construction during part or all of 2011. This list should include establishments of
your company and each of its subsidiaries. To make it easier for you to complete this report, we have prelisted information
in 5 A that you have previously provided to the U.S. Census Bureau. Please list all other establishments of your organization
on 5 B. Do not duplicate establishments already prelisted in 5 A. Be sure to include items 1 through 4 when returning your
completed report form. Before completing this form, please read the enclosed definitions and instructions.
1

COMPANY OWNERSHIP OR CONTROL
A. DOMESTIC OWNERSHIP OR CONTROL
1. Does another domestic company hold more than 50 percent of the voting stock of your company or have the
power to control the management and policies of your company?

99001018

0008

0080

Yes - Enter the following information of the owning or
controlling company
Name of owning or controlling company

0082

Home office address (Number and street)

0083

City, town, village, etc.

0081

No - Go to line B

0009

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

0084

State

-

0085

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
0027

Less than 50%

PENALTY FOR FAILURE TO REPORT

0028

50%

0029

More than 50%

Form NC-99001
1

(DRAFT)

COMPANY OWNERSHIP OR CONTROL - Continued
B. FOREIGN OWNERSHIP OR CONTROL
Does a foreign entity (company, individual, government, etc.) own directly or indirectly 10 percent or more of the
voting stock or other equity rights of your company?
Yes - Enter the following information of the owning entity and go to line C

6101
6103

Name of foreign beneficial owner

6104

Home office address (Number and street)

6105

City

6106

What was the percent
ownership (direct and
indirect)? (Mark "X" only
ONE box.)
6102

6111

10-24%

6113

50%

6112

25-49%

6114

51-99%

6115

Country

100%

No - Go to line C

C. FOREIGN AFFILIATES
Does this company alone, or with its domestic affiliates, own 10 percent or more of the voting stock of an
incorporated foreign business enterprise, or an equivalent interest in an unincorporated business enterprise,
including ownership of real estate?

2

6126

Yes

6127

No

RESEARCH AND DEVELOPMENT
A. Does your company perform or fund research and development (R&D)?
6129

Yes - Go to line B

6130

No - Go to line C

B. What were your company's worldwide expenses for research and development (R&D) in 2011?
6132

Less than $3 million

6133

$3 million or more

C. Did your company introduce any new or significantly improved methods of manufacturing, producing,
delivering or distributing goods or services during the years 2009 through 2011?
6135

99001026

3A

Yes

6136

No

EMPLOYEES FROM A PROFESSIONAL EMPLOYER ORGANIZATION
Did your company lease 50 percent or more of your permanent full- and part-time workforce from a Professional
Employer Organization during 2011? (Permanent workforce excludes temporary staffing from a staffing service
and contractors.)
0244

Yes

0245

No

HOW TO
REPORT
DOLLAR
FIGURES

Mark "X"
if None $ Bil.

Dollar figures should be rounded to
thousands of dollars.
If a figure is $3,025,628.79:

Report

If a value is "0" (or less than $500.00):

Report

2011
Mil.

Thou.

3 0 2 6

Dol.

Form NC-99001

(DRAFT)

3B OPERATING REVENUES AND NET SALES
A. Your company's operating revenues and net sales generated from U.S. operations (i.e., located in the 50 States
and the District of Columbia) in 2011.
Include:
• Sales of goods and services to foreign firms
• Revenues of discontinued operations
Exclude:
• Sales generated by your company's foreign operations
• Domestic inter-company sales
Special instructions for tax-exempt firms: Report revenues, realized gains and losses and contributions for
all classes of net assets regardless of restrictions.
Mark "X"
if None

Operating revenues and net sales . . . . . . . . . . . . . . . . . . .

2011
$ Bil.

Mil.

Thou.

Dol.

0100

B. Does the amount reported on line A include inter-company sales by your company's domestic operations to
foreign subsidiaries or foreign affiliates?
0000

Yes - Go to

0000

No - Go to line C

3C

99001034

C. If not already included on line A, report inter-company sales by your
company's domestic operations to foreign subsidiaries and foreign
affiliates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mark "X"
if None
0000

2011
$ Bil.

Mil.

Thou.

Dol.

Form NC-99001

(DRAFT)

3C ROYALTIES AND LICENSE FEES FOR THE USE OF INTELLECTUAL PROPERTY
A. Did your company's U.S. operations earn revenues in 2011 from royalties and license fees for rights to use
intellectual property?
Include:
• Revenues from royalties and license fees for intellectual property owned by your company's
domestic operations (i.e., located in the 50 states and the District of Columbia).
• Royalties and license fees paid to your company's domestic operations by foreign subsidiaries.
Exclude:
• Sales involving the transfer of ownership rights.
• Sales of and products sold as end-use licenses.
9701

Yes - Go to line B

9702

No - Go to

3D

Mark "X"
if None

B. Revenues from royalties and license fees for rights to use intellectual
property in 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2011
$ Bil.

Mil.

$ Bil.

Mil.

Thou.

Dol.

Thou.

Dol.

9703

C. Revenues from your company's U.S. operations, as reported in line B, for
the following types of royalties and license fees in 2011
Mark "X"
if None

1. Technological or industrial processes (Include patents, trade secrets,
and proprietary technology. Exclude computer software.) . . . . . . .

9704

2. Entertainment, artistic, educational, and literary original works (Include
royalties and license fees for rights to perform, broadcast, reproduce,
and sell copyrighted materials and other intellectual property such as
films, television and radio programs, written works, and musical and
other artistic works. Exclude computer software.) . . . . . . . . . .

9705

3. Software — Rights to reproduce, distribute, or use software protected
by copyright and owned or controlled by the licensor. (Exclude sales
of software sold with end-use licenses, as well as custom software
and programming services.) . . . . . . . . . . . . . . . . . . . .

9706

4. Business format franchise sales and fees included in line B, if any

. .

9707

. . . .

9708

99001042

5. TOTAL (Add lines C1 through C4. Total should equal line B.)

2011

Form NC-99001
3D

(DRAFT)

MANUFACTURING ACTIVITIES
In 2011, did your company do any of the following activities related to manufacturing?
A. Operate manufacturing facilities (such as a factory, plant, or mill) where products are completed or partially
produced?
9709

Yes

9710

No - Go to line C

B. Provide contract manufacturing services to other companies incorporating their patents, trade secrets, or
proprietary technology?
9711

Yes

9712

No - Go to line C
Estimate the percent of operating revenues and net sales, as reported in
services.
9713

Less than 25%

9714

25 to 49%

9715

50 to 74%

9716

75 to 99%

9717

100%

3B ,

from contract manufacturing

C. Purchase contract manufacturing services from other companies or foreign subsidiaries of your company
incorporating your company's patents, trade secrets, or proprietary technology?
9718

Yes

9719

No - Go to

4

1. Use 3rd party contract manufacturing services inside the U.S.?
9720

Yes

9721

No

2. Use 3rd party contract manufacturing services outside the U.S.?
9722

Yes

99001059

No
9723
3. Use your company's foreign subsidiaries' or affiliates' contract manufacturing services at locations outside
the U.S.?
9724

Yes

9725

No

4. Estimate the percent of the cost of sales from expenses for contract manufacturing services.
9726

Less than 25%

9727

25 to 49%

9728

50 to 74%

9729

75 to 99%

9730

100%

Form NC-99001

(DRAFT)

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

4 CERTIFICATION - This report is substantially accurate and was prepared in accordance with the instructions.
Name of person to contact regarding this report

Area code

99001067

Telephone

Number

Title

Extension

Area code

Number

Fax
Month

Internet e-mail address
Date completed

Day

Year


File Typeapplication/pdf
File TitleNC-99001 $$00 REPORT OF ORGANIZATION -
Authorstral001
File Modified2011-06-30
File Created2011-06-30

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